Qureos Mentor

UnitedHealthcare

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together 
As the Executive Director, Dual Special Needs Plan (DSNP ED), you will have the unique opportunity to manage a complex, innovative, and growing product line in collaboration with local Market Medicaid leadership and our nationally leading Medicaid team. The DSNP ED role will focus on delivering overall product results, including growth, medical expense and revenue management, quality and clinical outcomes, and integration and coordination of Medicaid and Medicare benefits. As the DSNP ED you will be accountable for developing deep state relationships to support the annual State Medicaid Agency Contracts (SMAC) Process as well as shaping state Medicaid strategy for integration and benefit coordination. In addition, this role will require deep knowledge of local community based supports and demonstrated relationships with local Community Based Organizations (CBO) and Medicaid service organizations such as Single Entry Point (SEP) and Area Agencies on Aging (AAA). This role will also serve as the accountable leader for collaboration with the Medicare Product Team for annual benefits and bid filing strategy. 
Dependent on market size and integration level, this role will allow for the DSNP ED to manage multiple markets. 
The successful candidate will have a deep understanding of both Medicaid and Medicare, understanding the manner in which these two programs work together to promote health and wellbeing for the most vulnerable, including those receiving long term services and supports (LTSS). The candidate will have a demonstrated ability to work in a matrixed environment, including collaborative goal setting with the local market CEO and national product team leaders. The DSNP ED will lead medical expense management strategies to address emerging trends, will collaborate with national Quality team members to drive continual STAR Rating performance, and will lead with a Person-First mindset to ensure our Medicaid and Medicare programs fully support our membership across all domains of care. 
The successful candidate will also be responsible for fostering close, mutually beneficial relationships with local community supports and providers, including but not limited to primary care medical homes, health systems, behavioral health providers, community leaders, community-based organizations, policymakers and consumer advocacy groups throughout the states. The Executive Director is a driver of solutions and partnerships that increase STARS rating of the health plans, close gaps in care and service delivery for members, and continuously improve access to care in the communities served. As a key leader among the health plans, the Executive Director assures that the health plans and their partners live up to service commitments for the communities served. 
If you are located in Missouri, Iowa, surrounding states or are willing to relocate, you will have the flexibility to work remotely* as you take on some tough challenges. 
Primary Responsibilities:<ul><li>
Functions as a member of the executive teams for the C&amp;S health plans being supported</li><li>
Direct oversight of the Dual Special Needs Plan (D-SNP) for multiple states</li><li>
Ensures compliance with applicable state and Federal laws and with contractual obligations to state Medicaid, providers and others</li><li>
Product P&amp;L ownership and matrixed and direct leadership across a complex organization</li><li>
End-to-end ownership of all related functions for assigned D-SNP markets including:<ul><li>
The development of market specific State Medicaid Agency Contract (SMAC) agreements and accountability for ensuring compliance with SMAC requirements</li><li>
Collaboration with Government Programs functional teams including but not limited to Product, Stars, Operations, Clinical, Sales and Marketing to ensure best in class delivery of Medicare Advantage programs</li><li>
Identification of market specific requirements and alignment with national vendor (clinical/non-clinical) options to support cost effective, proven solutions</li></ul></li><li>
Maintain awareness of and apply emerging state and federal policy requirements to market specific strategies</li><li>
In collaboration with clinical and Health Care Economics team, leads medical expense management strategies to manage trend and medical cost as well as promoting best outcomes</li><li>
Reporting and Analytics - in collaboration with national HCE, Finance, and Operations, develops and retains detailed reporting to enable effective management of the program, including but not limited to: trend drivers (DX and Provider type), member demographics, RAF/HCC reporting, detailed financials, integration status, etc.</li><li>
Develop and execute strategic priorities related to Highly Integrated Dual Eligible (HIDE) &amp; Fully Integrated Dual Eligible (FIDE) maturation, Accountable Care Organization (ACO) partnerships, community engagement, LTSS co-evolution including management of state relationship for DSNP integration (in collaboration with health plan CEO)</li><li>
Defines strategic priorities to support contract, SMAC, Risk Adjustment Factor (RAF), STARS and other quality standards</li><li>
Works closely with UHN partners to refine the DSNP network for optimal success including integration of providers, network adequacy and cost / quality / outcomes</li><li>
Ensures matrix partners provide excellent service to state customers, i.e., members and providers</li><li>
Works closely with Government Programs and M&amp;R CEOs to align on priorities when appropriate</li><li>
Assists in detecting service problems and coordinating solutions with the health plan, segments and corporate office</li><li>
Understands thoroughly and administers the contracts for the line of business within the applicable states</li><li>
Participates in formulating and administering company policies and developing long-range goals and objectives as they relate to the state health plans</li><li>
Represents the health plan professionally and effectively to customers such as state Medicaid and other important business relationships</li><li>
Establishes and maintains an excellent business reputation</li><li>
Monitors state activities, costs, operations, etc. to determine progress toward objectives and priorities</li><li>
Develop and maintain solid relationships within the key communities including providers, business partners, community alliances, etc.</li><li>
Continuously fosters innovation, improvement and positive differentiation in the assigned markets</li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
4+ years of experience in Medicaid and/or Medicare programs environment, care delivery models, VBC/APMs</li><li>
Experience in quality improvement, strategic planning and development</li><li>
Experience designing and/or administering health programs and developing health care policy</li><li>
Experience managing high-profile community projects or large-scale contracts</li><li>
Consistent, progressive leadership experience in health care delivery and public programs</li><li>
In-depth knowledge of the dual Medicaid - Medicare eligible populations including Behavioral Health and LTSS</li><li>
People management, including direct supervisory experience and ability to indirectly influence those outside of direct supervision</li><li>
Resident of Missouri, Iowa, surrounding states or willing to relocate</li><li>
Ability to travel up to 75%</li><li>
Driver's License and access to reliable transportation</li></ul> 
Preferred Qualifications:<ul><li>
Knowledge of and experience with the Medicaid waiver process</li><li>
Knowledge of and experience with Medicaid and Human Services systems within the served states, licensure processes, quality and financial oversight processes, including applicable federal and state regulations</li></ul><div><ul><li> 
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy</li></ul></div> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 - $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

DSNP Executive Director, Missouri and Iowa - Remote in MO, IA or surrounding area

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As part of a care management team who will manage complex members, the Integrated Care Coordinator will be the primary care manager for a panel of older adult members with a variety of medical and/or behavioral health needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.
Work Schedule: Monday through Friday 8:00 am to 5:00 pm
Location: Wayne County, Indiana and surrounding areas
Local travel up to 75% and mileage is reimbursed at current government rate.
If you live within the state of Indiana and can travel to Wayne County, IN and surrounding counties, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:<ul><li>
Serve as primary care manager and service coordinator for high medical risks / needs members with comorbid behavioral health needs</li><li>
Engage members face-to-face and/or telephonically to complete comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural and socioeconomic (SDoH) needs</li><li>
Develop and implement individualized, person-centered care plans and service plans inclusive of goals, opportunities and interventions/services aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the members where they are</li><li>
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan</li><li>
Provide referrals and linkage as appropriate and accepted by members (may include internal consulting opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Must Possess One of the Following:<ul><li>
Master's Degree in Social Work</li><li>
Bachelor's Degree in Social Work, Psychology, Special Education, Counseling, or relevant degree with at least 1+ years of case management experience with older adults, individuals with disabilities or those with serious mental illness</li></ul></li><li>
2+ years of experience in long-term support services or working with older adults</li><li>
1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.)</li><li>
1+ years of experience with MS Office, including Word, Excel and Outlook</li><li>
Ability to travel 75% of the time within assigned territory to meet with members and providers</li><li>
Reside in Indiana</li><li>
Access to reliable transportation &amp; valid US driver's license</li></ul>
Preferred Qualifications:<ul><li>
Demonstrated experience/additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care</li><li>
Experience working in team-based care</li><li>
Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)</li><li>
Background in Managed Care</li><li>
Bilingual in Spanish or other language specific to market populations</li></ul>
Physical Requirements<ul><li>
Ability to transition from office to field locations multiple times per day</li><li>
Ability to navigate multiple locations/terrains to visit employees, members and/or providers</li><li>
Ability to remain stationary for long periods of time to complete computer or tablet work duties</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $$29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO #RED</div>

Field Based Clinical Care Coordinator - Wayne County, IN

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As part of a care management team who will manage complex members, the Integrated Care Coordinator will be the primary care manager for a panel of older adult members with a variety of medical and/or behavioral health needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.
Work Schedule: Monday through Friday 8:00 am to 5:00 pm
Location: Morgan and Monroe County, Indiana and surrounding areas
Local travel up to 75% and mileage is reimbursed at current government rate.
If you live within the state of Indiana and can travel to Morgan and Monroe County, IN and surrounding counties, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:<ul><li>
Serve as primary care manager and service coordinator for high medical risks / needs members with comorbid behavioral health needs</li><li>
Engage members face-to-face and/or telephonically to complete comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural and socioeconomic (SDoH) needs</li><li>
Develop and implement individualized, person-centered care plans and service plans inclusive of goals, opportunities and interventions/services aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the members where they are</li><li>
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan</li><li>
Provide referrals and linkage as appropriate and accepted by members (may include internal consulting opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Must Possess One of the Following:<ul><li>
Master's Degree in Social Work</li><li>
Bachelor's Degree in Social Work, Psychology, Special Education, Counseling, or relevant degree with at least 1+ years of case management experience with older adults, individuals with disabilities or those with serious mental illness</li></ul></li><li>
2+ years of experience in long-term support services or working with older adults</li><li>
1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.)</li><li>
1+ years of experience with MS Office, including Word, Excel and Outlook</li><li>
Ability to travel 75% of the time within assigned territory to meet with members and providers</li><li>
Reside in Indiana</li><li>
Access to reliable transportation &amp; possess a valid US driver's license</li></ul>
Preferred Qualifications:<ul><li>
Demonstrated experience/additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care</li><li>
Experience working in team-based care</li><li>
Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)</li><li>
Background in Managed Care</li><li>
Bilingual in Spanish or other language specific to market populations</li></ul>
Physical Requirements<ul><li>
Ability to transition from office to field locations multiple times per day</li><li>
Ability to navigate multiple locations/terrains to visit employees, members and/or providers</li><li>
Ability to remain stationary for long periods of time to complete computer or tablet work duties</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO, #RED</div>

Field Based Clinical Care Coordinator - Morgan, Monroe County, IN

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 
The Manager of Clinical Annotation leads a team of Registered Nurse Clinical Annotators responsible for labeling and validating medical data used in training artificial intelligence models for prior authorization automation. This role combines clinical leadership, operational oversight, and cross-functional collaboration to ensure high-quality data annotation aligned with clinical standards, payer policies, and AI development goals. 
General Job Profile<ul><li>
Reviews the work of others</li><li>
Develops innovative approaches</li><li>
Sought out as expert</li><li>
Serves as a leader/ mentor</li></ul> 
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 
Primary Responsibilities:<ul><li>
Team Leadership &amp; Management<ul><li>
Supervise and mentor a team of RN Clinical Annotators</li><li>
Manage staffing, scheduling, performance reviews, and professional development</li><li>
Foster a culture of clinical excellence, data integrity, and innovation</li></ul></li><li>
Operational Oversight<ul><li>
Oversee daily annotation workflows and ensure timely delivery of annotated datasets</li><li>
Monitor quality metrics and implement continuous improvement strategies</li><li>
Ensure compliance with HIPAA and internal data governance policies</li></ul></li><li>
Clinical Quality Assurance<ul><li>
Review annotated data for clinical accuracy and consistency</li><li>
Develop and refine annotation guidelines and training materials</li><li>
Serve as a clinical escalation point for complex or ambiguous cases</li></ul></li><li>
Cross-functional Collaboration<ul><li>
Partner with data science, engineering, and product teams to align annotation efforts with model development needs</li><li>
Translate clinical workflows into structured annotation schemas</li><li>
Participate in model evaluation and provide clinical feedback on AI outputs</li></ul></li><li>
Strategic Planning<ul><li>
Contribute to roadmap planning for annotation projects and AI initiatives</li><li>
Identify opportunities to expand annotation capabilities or improve efficiency</li><li>
Stay current with payer policies, clinical guidelines, and emerging AI trends</li></ul></li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Active RN license with 5+ years of clinical experience</li><li>
2+ years in a leadership or supervisory role</li><li>
Experience in utilization management, case review, or payer operations</li><li>
Experience with clinical data annotation, health informatics, or AI-related projects</li><li>
Solid understanding of prior authorization workflows, payer criteria, and medical necessity documentation</li><li>
Knowledge of InterQual or other clinical decision support tools</li></ul> 
Preferred Qualifications:<ul><li>
BSN/MSN</li><li>
Excellent communication, organizational, and problem-solving skills</li></ul> 
Values Based Competencies
Employee<ul><li>
Integrity Value: Act Ethically<ul><li>
Comply with Applicable Laws, Regulations and Policies</li><li>
Demonstrate Integrity</li></ul></li><li>
Compassion Value: Focus on Customers<ul><li>
Identify and Exceed Customer Expectations</li><li>
Improve the Customer Experience</li></ul></li><li>
Relationships Value: Act as a Team Player<ul><li>
Collaborate with Others</li><li>
Demonstrate Diversity Awareness</li><li>
Learn and Develop</li></ul></li><li>
Relationships Value: Communicate Effectively<ul><li>
Influence Others</li><li>
Listen Actively</li><li>
Speak and Write Clearly</li></ul></li><li>
Innovation Value: Support Change and Innovation<ul><li>
Contribute Innovative Ideas</li><li>
Work Effectively in a Changing Environment</li></ul></li><li>
Performance Value: Make Fact-Based Decisions<ul><li>
Apply Business Knowledge</li><li>
Use Sound Judgement</li></ul></li><li>
Performance Value: Deliver Quality Results<ul><li>
Drive for Results</li><li>
Manage Time Effectively</li><li>
Produce High-Quality Work</li></ul></li></ul><ul><li> 
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Manager of Clinical Annotation - Remote

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
This position will be the primary care manager for a panel of members with primary complex medical needs. The Care Management / coordination activities will focus on supporting member's medical, behavioral and socioeconomic needs to promote appropriate utilization of services and improved quality of care. All case management/ coordination activities will be in alignment with evidence-based guidelines. This position will liaison with the members' provider community to help reduce fragmentation within the care ecosystem. The role will provide medically oriented clinical consults/guidance within the team and to other area within the health plan. The Clinical Care Manager will approach their member work with an understanding of how inequities drive health disparities. They will promote health equity.
Working Schedule: Schedule is Monday through Friday between the hours of 8 am to 5 pm.
Locations will vary but within the following counties of Florida: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union, Hardee, Highlands, Hillsborough, Manatee, Polk.
Preference for those residing in the following counties: Alachua, Clay, Duval, Flager, Nassau, St Johns, Volusia.
Local travel up to 10% and mileage is reimbursed at current government rate.
Primary Responsibilities:<ul><li>
Serve as primary care manager for members with primary complex medical needs</li><li>
Engage members through a variety of modalities (face and/or telephonically) to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, socioeconomic and SDOH needs</li><li>
Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines</li><li>
Partner and collaborate with internal care team, providers, community resources/partners and leverage expertise to implement care plan</li><li>
Monitor and update care plan, incorporating feedback from member to monitor compliance with interventions to achieve care plan goals</li><li>
Provide education and coaching to support:<ul><li>
Member self-management of care needs in alignment with evidence-based guidelines</li><li>
Lifestyle changes to promote health, i.e. smoking cessation, weight management, exercise</li></ul></li><li>
Assist member in development of personal wellness plan / health crisis plan</li><li>
Perform targeted activities and provide education to support HEDIS/STAR gap closure, including scheduling, reminding and verification of appointment to receive specific services</li><li>
Monitor compliance with medication regimen and make referrals to Pharmacist for medication review and recommendations</li><li>
Reassess and update care plan with change in condition or care needs</li><li>
Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission</li><li>
Access and Coordinate Medicaid Benefits to support care needs</li><li>
Document all care management/coordination activity in clinical care management record</li></ul>
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:<ul><li>
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays</li><li>
Medical Plan options along with participation in a Health Spending Account or a Health Saving account</li><li>
Dental, Vision, Life&amp; AD&amp;D Insurance along with Short-term disability and Long-Term Disability coverage</li><li>
401(k) Savings Plan, Employee Stock Purchase Plan</li><li>
Education Reimbursement</li><li>
Employee Discounts</li><li>
Employee Assistance Program</li><li>
Employee Referral Bonus Program</li><li>
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Current, unrestricted, independent licensure as a Registered Nurse for state of Florida</li><li>
4+ years of relevant clinical work experience</li><li>
3+ years of experience managing needs of complex populations (e.g. Medicare, Medicaid)</li><li>
1+ years of community case management experience coordinating care for individuals with complex needs</li><li>
Intermediate level of knowledge of Medicare and Medicaid benefits</li><li>
Ability to travel 10% of the time for role</li><li>
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information and live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service</li><li>
Reside in the state of Florida</li></ul>
Preferred Qualifications:<ul><li>
Master's degree in nursing or related clinical field</li><li>
Experience working with behavioral health issues that can be applied to help guide and support members with behavioral health needs</li><li>
Experience working in team-based care</li><li>
Bilingual in English/Spanish</li><li>
Experience working in Managed Care</li><li>
Lived experience (self or family) in managing or overcoming chronic health, behavioral health or substance use condition</li></ul>
Soft Skills:<ul><li>
Possess a strong work ethic</li><li>
Ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner</li><li>
Ability to adapt to change in the workplace</li><li>
Ability to work independently and as a part of a team</li><li>
Ability to interact with internal and external customers in a corporate environment</li><li>
Must possess a positive and motivated attitude</li><li>
Willingness to adapt to multiple external environments and settings</li></ul>
Physical Requirements and Work Environment:<ul><li>
Must possess transportation to visit clients in various locations</li><li>
Ability to travel varied distances and multiple terrains to visit assigned client locations</li><li>
Ability to carry equipment to and from field locations needed for face to face member visits (ex. laptop, stethoscope, blood pressure cuff, etc.)</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO #GREEN</div>

HSS Clinical Coordinator RN - Florida

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:<ul><li>
Develop and implement effective/strategic business solutions through systematic data engineering and research</li><li>
Evaluate and present information in a manner that will facilitate management's understanding of the results and impacts</li><li>
Building relationships with key business partners of key dashboards</li><li>
Collaborate a diverse global team who builds and maintains dashboards for major corporate initiatives</li><li>
Analyze, review, forecast, and trend complex data</li><li>
Develop, implement, enhance, maintain Business Intelligence reporting and dashboards</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Bachelor's degree in business, Mathematics, Statistics, Economics or similar field</li><li>
5+ years of experience utilizing SQL (T-SQL or Snow SQL) and/or data exploration tools (such as SAS or R)</li><li>
5+ years of experience performing data analytics</li><li>
2+ years of experience with Tableau or Power BI</li><li>
Advanced level of proficiency in user skills in Excel, Word, and PowerPoint</li></ul>
Preferred Qualifications:<ul><li>
3+ years' experience in the healthcare industry</li><li>
Demonstrated ability to prioritize deliverables</li><li>
Proven organizational skills with ability to be flexible and work with ambiguity</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $91,700 to $163,700 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO #GREEN</div>

Senior Data Analyst - Remote Nationwide

<div>At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.
Expect to spend about 80% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Do you live or are you willing to travel to any of the following counties? Hudson and Surrounding Counties, NJ 
Primary Responsibilities:<ul><li>
Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs</li><li>
Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines</li><li>
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan</li><li>
Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health</li><li>
Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission</li><li>
Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team</li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Current, unrestricted independent licensure as a Registered Nurse in New Jersey</li><li>
2+ years of clinical experience</li><li>
1+ years of experience with MS Office, including Word, Excel, and Outlook</li><li>
Driver's license and access to reliable transportation and the ability to travel up to 80% of your time within assigned territory to meet with members and providers</li></ul> 
Preferred Qualifications:<ul><li>
BSN, Master's degree or higher in clinical field</li><li>
CCM certification</li><li>
1+ years of community case management experience coordinating care for individuals with complex needs</li><li>
Experience working in team-based care</li><li>
Background in managed care</li></ul> 
Physical Requirements:<ul><li>
Ability to transition from office to field locations multiple times per day</li><li>
Ability to navigate multiple locations/terrains to visit employees, members and/or providers</li><li>
Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.)</li><li>
Ability to remain stationary for long periods of time to complete computer or tablet work duties</li></ul><div><ul><li> 
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul></div> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $40.00 to $54.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

RN Clinical Coordinator - Field Based in Hudson and Surrounding Counties - NJ

Join UnitedHealthcare and explore 11   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.