Qureos Mentor

UnitedHealthcare

UnitedHealthcare is dedicated to helping people live healthier lives and improving the health system for everyone. They offer a range of health plans designed to provide affordable coverage and supportive care, ensuring a simple experience for members. As part of the UnitedHealth Group, UnitedHealthcare connects with over 1.3 million physicians and 6,500 hospitals globally, focusing on high-quality care tailored to individual needs and community requirements. Their commitment to integrity, compassion, and innovation drives their mission to enhance healthcare accessibility and quality.

<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? Camden County, 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>
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> 
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.</div>

RN Clinical Coordinator - Field Based in Camden County - NJ

<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 Director of Product, Behavioral is responsible for developing a behavioral health solution for the intellectual developmentally disabled (IDD) population and a behavioral health delegation strategy including evaluating potential partners. This role is accountable for delivering solutions that not only meet the expectations of our members and state customers but also differentiate C&amp;S competitively through measurable consumer impact. 
A critical component of this role is deep partnership with the C&amp;S clinical team. The Director will work side by side with clinical leadership to translate clinical strategy into scalable product, partner, and market approaches-ensuring clinical priorities are embedded in partnerships, operational execution, and member experience. 
The Director will also collaborate closely with local markets to understand market-specific nuances, the growth team to identify market needs and help develop RFP responses, the consumer experience team to develop an experience strategy, and the policy team to proactively assess how the evolving policy landscape influences product design. The overarching vision is a continuously refined strategy, grounded in clinical insight, data, customer feedback, and enterprise capabilities. 
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. 
Primary Responsibilities:<ul><li>
Partner closely with the C&amp;S clinical team to design and operationalize a behavioral health strategy that meets the unique clinical and social needs of the IDD population</li><li>
Build and maintain a comprehensive external market view for the IDD population, including market dynamics, competitive landscape, state trends, and member and population health insights</li><li>
Partner with the consumer experience team to deliver a cohesive, clinically aligned end-to-end member experience</li><li>
Develop a behavioral health delegation strategy, including defining clinical and operational requirements, evaluating partners, negotiating contracts, and monitoring ongoing performance</li><li>
Work with growth and marketing teams to develop RFP responses and sales materials that clearly articulate our differentiated strategy</li><li>
Continuously refine the product strategy by incorporating data, clinical insights, and market feedback into forward-looking plans</li><li>
Partner with finance, actuarial, and clinical teams to interpret pricing models and cost and utilization trends, identify affordability opportunities, and own year-over-year pricing recommendations informed by product, clinical, and market strategy</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>
7+ years of experience product development/management</li><li>
Healthcare Industry experience.</li><li>
Experience in leading complicated, cross-functional projects</li><li>
Experience with behavioral health product design</li><li>
Experience in complex, matrix organizations; knows how to get things done both through formal channels and the informal network</li><li>
Demonstrated leadership ability with cross-functional teams and consensus builder</li><li>
Proven good negotiation, problem solving, planning and decision-making skills. Accurately scopes out projects, sets objectives and goals, develops schedules and resource assignments, measures performance against goals, and evaluates results</li><li>
Proven ability to manage projects simultaneously and achieve goals. Uses resources effectively and efficiently</li><li>
Prove solid analytical skills. Demonstrates ability to use data to drive action</li></ul> 
Preferred Qualifications:<ul><li>
Experience with Medicare Advantage, Medicaid Managed Care and/or DSNP health plans</li><li>
Experience with intellectual developmentally disabled (IDD) population</li><li>
Experience with delegation of health plan functions</li><li>
Knowledge of health plan management (network, operations, clinical)</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 $134,600 to $230,800 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>

Director of Product, Behavioral Health - 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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Clinical Review Dentist is a production role that supports the dental director on claims review. Strong knowledge of dental procedures, terminology and related dental codes along with strong computer and communication skills are crucial to this role.
*** Candidate must be available to work weekdays from 8:00 am - 5:00 pm PST and 8:00 am - 12:00 pm PST every other Saturday and Sunday. ***
Primary Responsibilities:<ul><li>
Review of claims and supporting clinical data to provide accurate documentation for the dental director</li><li>
Accurate interpretation of radiographs, intra-oral photographs and clinical narratives</li><li>
Maintain organization and department defined standard of performance to meet metrics</li><li>
Communication with provider offices in accordance with compliance regulations to discuss adverse clinical determinations and to request missing information</li><li>
Independently manage individual queue assignments and workflow to meet deadlines, business needs and department and individual metrics</li><li>
Acts as a liaison between our dental directors and provider offices to maintain provider/member satisfaction</li><li>
Perform individual case review for appeals and grievances. The Appeals are in response to adverse determinations for dental services related to benefit design and coverage, medical necessity and the application of clinical criteria and dental policies, the Clinical Grievances are related to the quality of care provided by contracted dentists</li><li>
Participate in peer-to-peer calls with dental providers</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>
Dental degree from an Accredited Dental School</li><li>
Active and unrestricted dental license for the state of California</li><li>
7+ years of experience in clinical dentistry</li><li>
3+ years dental benefit plan experience with specific exposure to claim review and utilization management or comparable experience.</li><li>
Ability to pass a credentialing review for practice experience</li><li>
Proficient in Microsoft Word, Excel and PowerPoint</li><li>
Excellent business analytical and writing skills</li></ul>
Preferred Qualifications:<ul><li>
Active Dental License in Texas</li><li>
Experience with Dental Compliance related to Federal Regulations</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 $112,700 to $193,200 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>

Clinical Review Dentist - PST time zone

<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 Clinical Program Director of Brain and Behavior is responsible for ideating, designing, and developing innovative specialty clinical programs focused on Neurological and Behavioral Health Conditions. This role aims to improve affordability, health outcomes, and member and provider experience. The Director manages a small team of program managers and works with healthcare analytics, clinical implementation technology, and medical management teams to develop and monitor Brain and Behavior focused Clinical Programs at United Healthcare. The Director reports to the National Medical Director of Behavioral Health at UnitedHealthcare Clinical Services. The ideal candidate combines clinical expertise, strategic thinking, a flexible mindset, and program development skills to create impactful solutions for members and providers. 
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 
Primary Responsibilities:
Clinical Program Ideation and Design:<ul><li>
Use clinical, claims and quality data and knowledge of emerging trends in the specialty care industry to identify key opportunities to design large-scale, enterprise-level clinical management programs that drive meaningful affordability, quality, and experience outcomes across diverse populations and lines of business</li><li>
Leverage advanced analytics, including artificial intelligence (AI) and large language models (LLMs) when appropriate to enhance program design efficiency, automate insights, and identify innovative clinical pathways that support proactive and personalized care</li><li>
Use clinical, claims, and quality data to identify high-impact cost drivers, utilization trends, and care variation at scale</li><li>
Conceptualize new clinical programs that incorporate technology-enabled care models, digital engagement strategies, and modern decision-support tools for pre and post service medical management and value-based care</li><li>
Build feasibility business cases and financial models to assess operational readiness and impact when implemented at scale</li><li>
Incorporate evidence‑based medical policies, clinical guidelines, and a broad spectrum of actionable insights - including claims data, clinical outcomes data, utilization trends, quality metrics, member‑reported outcomes, digital engagement signals, market intelligence, provider performance patterns, and operational throughput data - gathered across markets, providers, and enterprise data sources</li><li>
Foster stakeholder alignment and cross-functional collaboration to ensure programs are designed to support national scalability, operational sustainability, and continual innovation</li></ul>
Data-driven strategy:<ul><li>
Analyze claims utilization and variation, clinical, and quality data to identify opportunities for clinical program development and improvement</li><li>
Use clinical insights and knowledge to inform program design and measure impact</li><li>
Work with program managers and analytics teams to accurately model performance expectations to correlate the expected affordability to the operational reality of the program</li><li>
Analyze appeal trends, overturn rates, peer-to-peer outcomes, and clinical documentation to develop targeted interventions, provider feedback loops, and continuous improvement plans</li><li>
Collaborate with analytics teams to develop Key Performance Indicators and to build dashboards tracking program performance</li></ul>
Stakeholder Collaboration<ul><li>
Seek input from network teams, market teams and external vendors to develop program models</li><li>
Build and maintain solid relationships with executive leadership across internal teams to ensure effective support and feedback loops and that deliverables are met</li><li>
Develop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programs</li><li>
Collaborate with Regulatory and Compliance Teams to ensure program compliance with state and federal regulatory requirements</li></ul>
Communication and Presentation Skills<ul><li>
Speak clearly on complex problems across a wide range of audiences</li><li>
Prepare decks and executive summaries for regular updates regarding the clinical program development and performance for Joint Operating Committees, Team Leadership and Executive Sessions</li></ul>
Program Implementation<ul><li>
Use problem solving skills and make decisions to support program design and feasibility prior to transition to the Clinical Services Implementation team</li><li>
Actively participate in clinical, business and operational meetings; ensure business partners, stakeholders and senior management are provided relevant and timely information on the clinical program design and scope for the approval process</li><li>
Provide support to the Clinical Services Implementation team and project managers responsible for moving the program initiative through the clinical implementation lifecycle end-to-end</li><li>
Actively participate in multidisciplinary teams to achieve program deliverables; Foster and promote collaborative relationships with matrix partners/stakeholders; Establish trust and credibility at all levels of the organization</li><li>
Work independently and as a team member</li></ul>
Program oversight and Continuous Improvement<ul><li>
Monitor clinical program performance and Key Performance Indicators and iterate based on feedback and data</li><li>
Ensure program compliance with state and federal regulatory requirements; collaborate with Regulatory and Compliance Teams to develop and implement new regulatory and compliance requirements</li><li>
Solve unique and complex problems with broad impact on the business; translate highly complex concepts in ways that can be understood by a variety of audiences, including senior management</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>
Experience<ul><li>
Advanced Degree including Master's degree or PhD in healthcare administration, public health, social services, nursing or a related clinical specialty, or MBA plus clinical background in neurological diseases.</li><li>
5+ years in a leadership or management role in healthcare</li><li>
5+ years of healthcare experience with operational accountability</li><li>
Demonstrated ability to design, scale, or operationalize enterprise-level clinical programs or value-based care models across multiple markets or lines of business</li></ul></li><li>
Clinical Expertise<ul><li>
Deep clinical understanding of brain and neurodegenerative conditions</li><li>
Familiarity with evidence-based clinical guidelines and policies</li><li>
Proven ability to apply clinical insights to program design and outcome measurement</li></ul></li><li>
Regulatory Knowledge<ul><li>
Familiarity with health plan regulatory and accreditation requirements</li></ul></li><li>
Data &amp; Analytics Proficiency<ul><li>
Skilled in analyzing claims, clinical, and quality data to drive new clinical insights and identify opportunities for program development and inform program design</li><li>
Proven ability to work with healthcare analytics teams to model performance expectations and measure clinical and financial impact</li></ul></li><li>
Leadership Skills<ul><li>
Demonstrated experience setting clear goals, providing regular feedback, and conducting performance evaluations to support career growth and talent retention</li><li>
Skilled in guiding teams through ambiguity, change, and complex problem‑solving while maintaining clarity, engagement, and accountability</li><li>
Proven ability to lead, coach, and develop small teams of program managers or clinical professionals, fostering a supportive, high‑performance culture</li><li>
Proven solid commitment to collaboration - encouraging cross‑functional communication, resolving conflicts constructively, and building trust within and across teams</li><li>
Proven self-starter, initiates work independently</li></ul></li><li>
Communication and Presentation<ul><li>
Proven ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations</li><li>
Solid negotiation skills: Proven ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome</li></ul></li><li>
Technical Skills<ul><li>
Proficiency with MS-Word, Excel, and PowerPoint</li></ul></li></ul> 
Preferred Qualification:<ul><li>
Experience applying AI-enabled analytics, machine learning tools, or large language model (LLM) capabilities in healthcare program design, clinical operations, or outcome measurement</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 $134,600 to $230,800 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>

Clinical Program Director of Brain and Behavior - 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 optimized. 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 Field Case Manager will be the primary care manager for a panel of members with complex behavioral health needs (i.e., mental health or substance use disorders). Additionally, this position will provide behavioral health support to the broader team. 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. Reliable transportation is required. Candidate must be willing to travel up to 50 miles radius from their home base to fulfill job responsibilities within the designated territory. 
Primary Responsibilities:<ul><li>
Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs</li><li>
Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs</li><li>
Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are</li><li>
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan</li><li>
Provide referral and linkage as appropriate and accepted by member (may include internal consult 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 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-year or higher degree in a behavioral health related field (e.g., Social Work, Psychology, Counseling, etc.)</li><li>
2+ years of experience directly serving individuals with behavioral health conditions (mental health / substance use disorders) or individuals in long-term care, home health, hospice, public health or assisted living</li><li>
1+ years of experience with local behavioral health providers and community support organizations (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>
Driver's license and access to reliable transportation and the ability to travel up to 80% of your time within assigned territory (50 miles radius from their home base) to meet with members and providers</li></ul> 
Preferred Qualifications:<ul><li>
Current, unrestricted independent licensure as a Social Worker</li><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>
Background in Managed Care</li><li>
Bilingual in Spanish/English</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><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 hourly pay for this role will range from $28.94 to $51.63 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>

Case Manager - Field Based in Bergen and Surrounding Counties - New Jersey

<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 Business Analyst role is responsible for analyzing, organizing, and managing complex datasets to support the development, optimization, and training of the AI platform. This position works cross functionally with clinical, operational, and technical teams to understand data needs, identify gaps, and translate business, clinical, and workflow requirements into clear, actionable data insights. 
The position prepares high quality data visualizations, dashboards, and executive level presentations that inform strategic decisions, monitor model performance, and ensure alignment with organizational goals. Through rigorous data evaluation and collaborative problem solving, the role strengthens model accuracy, supports continuous improvement initiatives, and advances the effective deployment of AI across the enterprise. 
General Job Profile<ul><li>
Generally work is self-directed and not prescribed.</li><li>
Works with less structured, more complex issues.</li><li>
Serves as a resource to others.</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>
Analyze, organize, and manage complex datasets to support CAVA model development, optimization, and training</li><li>
Collaborate cross functionally with clinical, operational, analytics, and technical teams to gather data requirements and ensure alignment with business objectives</li><li>
Identify data gaps, quality issues, and integration needs; recommend solutions to enhance data readiness for model training and evaluation</li><li>
Translate clinical and operational requirements into actionable data insights and model supporting datasets</li><li>
Develop high quality data visualizations, dashboards, and reports that clearly communicate findings and support decision making</li><li>
Prepare executive level presentations that summarize model performance, impacts, risks, and opportunities</li><li>
Monitor and interpret model performance metrics; escalate issues and provide recommendations for improvement</li><li>
Ensure data accuracy, integrity, reproducibility, and compliance with organizational data governance and regulatory standards</li><li>
Apply consistent formatting, clarity, and messaging across all visualizations, dashboards, and presentations</li><li>
Engage proactively with stakeholders to clarify requirements, manage expectations, and communicate findings in clear, accessible language</li><li>
Maintain documentation, best practices, and knowledge related to data processes, workflows, and model readiness</li><li>
Identify and implement opportunities to streamline data workflows and continuously improve analytical and model support processes</li><li>
Remain up to date on best practices in analytics, AI/ML, healthcare data, and clinical operations to enhance overall model development and deployment</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>
3+ years of experience in data analysis, healthcare analytics, clinical operations analytics, or a comparable analytical role</li><li>
Experience working with healthcare datasets such as EHR, claims, care management, or operational data</li><li>
Proficiency in SQL for data extraction and manipulation</li><li>
Experience with analytical and statistical tools such as Python, R, or SAS (Python preferred)</li><li>
Proficiency in data visualization tools such as Power BI, Tableau, or similar platforms</li><li>
Demonstrated ability to translate clinical and operational requirements into clear, actionable data insights</li><li>
Demonstrated ability to develop executive level presentations and communicate analytical findings to senior leadership</li></ul> 
Required Qualifications:<ul><li>
Familiarity with AI/ML concepts, model performance metrics, and data preparation practices</li><li>
Excellent written and verbal communication skills, with the ability to clearly explain technical information to non technical audiences</li><li>
Solid cross functional collaboration skills with the ability to work effectively with clinical, operational, product, and data science partners</li><li>
Solid analytical and problem solving skills, with the ability to identify data gaps and quality issues</li><li>
High attention to detail with a commitment to data integrity, accuracy, and governance standards</li><li>
Ability to manage multiple priorities in a fast paced environment while maintaining high quality work</li><li>
Self motivated, curious, and committed to continuous learning and process improvement</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 - Business Analyst - Remote

<div>This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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 a Long-Term Disability Claims Specialist, your primary responsibilities will be assessing eligibility for Long Term Disability benefits, and reviewing for ongoing medical, vocational, and financial accuracy.
This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer 3-5 weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment. 
Primary Responsibilities:<ul><li>
Providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjudicating Long Term Disability claims</li><li>
Communicating ongoing status and decisions both in writing and verbally</li><li>
Authorizes the appropriate payment or refers claims to SME or Manager for validation of adverse or over limit approvals</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>
High School Diploma / GED OR equivalent work experience</li><li>
Must be 18 years of age OR older</li><li>
1+ years of reviewing and rendering initial liability determinations on Long Term Disability claims</li><li>
1+ years of experience issuing monthly payments on Long Term Disability claims</li><li>
Experience with Microsoft Word (ability to create, modify and send documents)</li><li>
Experience with Microsoft Excel (ability to create, modify and send spreadsheets)</li><li>
Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasionally overtime or weekends</li></ul> 
Telecommuting Requirements:<ul><li>
Ability to keep all company sensitive documents secure (if applicable)</li><li>
Required to have a dedicated work area established that is separated from other living areas and provides information privacy</li><li>
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service</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 $49,700 - $88,800 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 is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Long Term Disability Claims Specialist

Join UnitedHealthcare and explore 19   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.