Fond du Lac Jobs

Details: Facility: Presence Saint Joseph Hospital - Chicago, Chicago, IL Department: RECOVERY ROOM Schedule: Full-time Shift: Day/PM rotation Hours: 830am-500pm, 1100am-730pm Req Number: 138919 Job Details: PATIENT CARE TECHNICIAN FULL TIME The Patient Care Technician under the direction and supervision of the professional nurse performs various duties to assist the nursing staff in meeting patient treatment and care requirements. All duties are carried out in accordance with the established policies and procedures. Adheres to the mission, values and philosophy of Presence Health. This position will rotate between the 8:30AM- 5PM and 11AM- 7:30 PM shifts. This position rotates weekends. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Provides direct patient care as assigned by the registered nurse (RN). 2. Performs routine patient care procedures (e.g. vital signs, height and weight, intake and output, specimen collections – urine/stool/sputum, and hygiene care). 3. Occasionally provide routine, low complex services generally performed by a Nursing Assistant, EKG Tech, Phlebotomist, or Respiratory Tech. 4. Documents care per documentation standards in electronic medical record. 5. Assists with patient’s activity and providing a safe environment. 6. Observes patient while performing delegated tasks and reports any changes in patient’s condition to the RN. 7. Promotes and maintains an atmosphere for patient comfort. Keep patient’s room clean and orderly. 8. Provides skin care and is knowledgeable in care needed to maintain or improve skin integrity. 9. Assists with admissions, transfers and morgue transport and discharge of patient. 10. Replenishes patient’s supplies as needed. 11. Identifies patient/family education needs and reports them to the RN. QUALIFICATIONS Education and/or Experience •CNA or one year patient care technician experience in a healthcare setting; students currently enrolled in an approved nursing school program may be considered. •CPR certification Certificates, Licenses, Registrations BLS certification required Nursing Assistant certification required or equivalent Presence Health is the largest health system based in Illinois, created in November 2011 through the merger of Provena Health and Resurrection Health Care. With over 150 locations, from physician offices and convenient outpatient centers to quality hospitals and senior living communities, we’re in communities big and small. Visit presencehealth.org to learn more. EOE of Minorities/Females/Vets/Disability PI90273318

Details: For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) Field-based (On-site) Case Managers will lead the new frontier in care coordination in the emerging provider market through full partnerships with health systems, hospitals, physicians, communities, patients and their families. In this role, the Case Manager will interact and collaborate daily with hospital licensed caregivers, health system physicians, internal and external vendors, patients and families. The Field-based Case Manager will be integral to the identification of population health management opportunities as well as the strategic development and design of these services. Value is demonstrated through a reduction in the hospital readmission rates of select patients and improved adherence to evidence based medicine guidelines and industry quality standards. The Case Manager implements wide reaching change by contributing to the transformation of a health care system that meets the demand for safe, quality, patient centered and affordable care. Part Time- 20 hours Working out of Phoebe Putney Primary Responsibilities: Manage targeted population daily census Identify those patients appropriate for face to face contact Meet with patients and caregivers/families while inpatient to establish relationship and engage in transitional case management process Assess adequacy of discharge plan and risk associated with compliance Complete assessments, address any identified barriers to compliance across the continuum Develop care plan and interventions with patient and family input Proactive post discharge follow-up; telephonically or in home as appropriate Coordination of post discharge care with primary care physician Interact in a collegial and collaborative fashion with hospital clinical staff to include: RN's, Social Workers, UR/UM, physicians, and nonclinical support staff Communicate regularly with patients and families, with hospital team, and document regularly in required systems for outcome reporting Promote cost effective health care with aligned health system networks

Details: We have an immediate opening for a Senior ETL Developer reporting into the Manager of Technology Delivery for Healthcare Measurement Portfolio – part of OptumInsight Optum Data Management (ODM). Ideal candidate will be an enthusiastic problem-solver who is comfortable taking charge, making good decisions and formulating creative tactical solutions to business and operational problems, all while handling multiple tasks simultaneously. Join our highly specialized IT team of problem solvers, leaders and doers. This individual contributor will be part of an ETL development team dedicated to acquiring, integrating and using administrative (claims) and supplemental (EMR, immunization etc.) data for quality programs (HEDIS, View360, M&R STAR, and Value-based Reimbursement). Primary Job Responsibilities: Part of the Solution Design and Delivery team with healthcare measurement and engagement portfolio (HCME) Research, evaluate, identify alternative approaches to support development needs Recommend, design and develop efficient and effective solutions for challenging problems for medium to large work efforts of medium to high complexity Comply with standards and guidelines related to the design, construction, testing, and deployment activities within the Delivery Management environments Demonstrate collaborative skills working within a project team of diverse skills Bring strong communication skills including verbal, written and presentation skills plus creativity, and problem solving skills to a challenging environment Support development, QA, and production support teams in SDLC and operational activities Identify opportunities in business processes, system capabilities and delivery methodologies for continuous improvement

Details: This isn't HR. This is Human Capital at UnitedHealth Group. Here, you're expected and empowered to be your best, to grow and to develop your skills. Join us and help people live healthier lives while doing your life's best work.(sm) This position is for a Trainer supporting the Optum Shared Services - Transactions organization, including the Claims Operations, Payment Integrity, and Advanced Analytics Labs business units. Chief responsibilities of this position will be to deliver the training curriculum needed to support the business units serviced. The person will deliver process, procedure, and systems training for multiple claim platforms and ancillary systems associated with Optum or its clients through the UHG cultural / values lens. May also deliver soft skills training. The candidate may work closely with the Operational Teams to identify training opportunities and implement strategies to conduct that training and make the staff more efficient. Additionally, they may network across other areas of Optum Shared Services - Transactions Training to broaden their knowledge base and expand the training offering. Primary Responsibilities: Training Delivery - 60-70% Conduct training for newly hired operational team members on core systems, processes, and applications Provide training on culture and values aligned with Our United Culture Deliver training using multiple mediums - classroom, webinar, blended learning approaches Deliver continuing education, up skill, and performance improvement training as necessary Provide feedback on trainee performance in the classroom to Operational Leaders Training Preparation, Development, and Follow Up - 20-30% Develop ad hoc training as needed Participate in the instructional design and development process as necessary for large scale curriculum design projects Update existing curriculum ahead of learning events - including gathering of examples, activities, etc. Secure room / facility resources as necessary to provide for successful training Create new / validate existing lesson plans with Operations Managers Provide feedback to trainees and Operations Managers regarding class progress, areas of strength and areas of improvement May enroll and grant credit in Learning Management System for courses administered Maintain expertise as needed in functional areas supported needed Other Duties As Assigned - 5-10%

Details: This IT Quality Manager will support overall Quality and Software testing efforts for the Optum Financial Portals team. This Manager will work closely with the QA Director in developing test strategy, Quality improvements, Agile process opportunities, Data management needs and directing test execution, defect management and risk mitigation for multiple scrum teams. This is a hands-on technical manager role requiring approximately 50% hands on project support and development of test strategies for projects. The IT Quality Manager will insure that the QA process is defined, reviewed and successfully executed through all phases of the software development lifecycle. Primary Responsibilities: Coordinates, supervises and is accountable for the daily activities for the on-shore & off-shore QA team Manage, coach and mentor the quality team Work with product managers, systems analysts, business analysts, designers and programmers to ensure quality processes are incorporated within the Agile process Participate in analysis, walk through, inspections, code reviews and user group meetings Provide input to estimations and design to provide QA input Work with Agile scrum team to clarify requirements, understand design/solution requirements, evaluate testing steps and test case, execute and supervise execution of test case, log test results and provide feedback to Analysts and Developers on test results Works closely with System Analysts, Project Managers, Development Team, Operation Team and Release Managers to guide proper timing/resource allocations of each testing piece within a project of QA SDLC Create guidelines for executing manual regression test and automated testing. Work closely with SME's to make sure that test cases and test strategy cover every aspect to catch defects in earliest possible stage of testing. Developing and implementing efficient and effective test strategy/plans for large, complex projects Bring business prospective in testing and focus on meeting business needs by coaching team on performing data analysis Work with team to create, update and execute automated test scripts for product features based on requirements Responsible for evaluating all identified and entered defects encountered during testing Create and maintain test data Will be managing and working with QA automation, performance testing teams in creating automation and performance testing framework Will be working with end users and SME's to implement UAT Best Practices Sets priorities for the team to ensure task completion Coordinates work activities with other supervisors Develops plans to meet short-term objectives and longer-term strategic objectives Identifies and resolves operational problems using defined processes, expertise and judgment

Details: Southwest Medical Associates (SMA) is a multi-specialty group of physicians, Nurse Practitioners, and Physician Assistants consisting of over 200 providers, fourteen clinical locations including nine health care centers, five urgent care clinics and an outpatient surgery center. SMA offers patients compassion, innovation, and quality care throughout southern Nevada. SMA is headquartered in the greater Las Vegas, NV area. Southwest Medical Associates is now part of the Optum division under the greater UnitedHealth Group umbrella. Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm) We offer patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health. Our employees work with professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. We run a systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. We offer an attractive base salary, sign on bonus, quarterly bonus plan, and comprehensive fringe benefits package, including medical, dental, and life insurance, STD/LTD, professional liability, matching 401K, relocation costs, three weeks paid vacation, one week paid CME with $3500 allowance, and eight paid holidays. Differential for supervision of extenders. Southwest Medical Associates has an exciting practice opportunity for a board-certified or board-eligible Cardiologist at our Las Vegas, NV. clinic. This is an employed practice position, 100% outpatient, no nights or weekends. In this role, you will be responsible for the performance and application of diagnostic and therapeutic procedures related to cardiovascular disease. You will work collaboratively with other cardiologists located in the same clinic, work in a fast paced, team-oriented environment and direct and provide patient care for a broad range of clinical presentations. As a leader of a multidisciplinary team, you will provide comprehensive, coordinated, and supportive care to patients and their families. Primary Responsibilities: Provides and administers all aspects of care, evaluation and management of the patient with cardiovascular disease Reads, interprets and reports on all testing modalities in the SMA Cardiology department Utilize skills and experience in pathogenesis, pathology, risk factors, natural history, diagnosis by history, physical examination and laboratory methods, medical and surgical management, complications and prevention of cardiovascular conditions, including coronary artery disease, hypertension, valvular heart disease, congenital heart disease, cardiac arrhythmias, heart failure, cardiomyopathy, involvement of the cardiovascular system by systemic disease, infective endocarditis, diseases of the great vessels and peripheral blood vessels, diseases of the pericardium, pulmonary heart disease, the interaction of pregnancy and cardiovascular disease, cardiovascular complications of chronic renal failure, traumatic heart disease and cardiac tumors

Details: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 14 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm) Primary Responsibilities: The Senior Project Manager position is responsible for managing medium to large sized projects and programs, often of varying scope, high complexity and non-contained risk. Projects will often be concurrent or overlap. Responsibility includes the business and technical sides of client, partner, compliance, information technology, operations, and human resources initiatives. Project Planning/Management Define the project from a business need, including business case/return on investment, and create momentum and project acceptance Deliver on project objectives by developing and managing cost, schedule, resources, scope, risks, decisions, and issues Manage competing needs of multiple stakeholders Project Progress & Communications Assess and manage project variances (e.g. schedule, budget variance); evaluate impacts to overall project commitments, evaluate and present options, and implement approved changes Maintain accountability for providing timely communications, managing expectations, and assuring quality Leadership/Decision Making Lead and influence change to people, process, and technology. Influence decisions with a degree of critical thinking and with a grasp of the strategic intent of the project Provide tactical leadership regarding project priorities, timeline, resources, budget, and issues Provide ongoing work direction to project team Build and develop successful teams, partnerships with key stakeholders Provide performance feedback for team members as appropriate Promote collaboration, teamwork, and knowledge exchange. Mentor/coach less experienced teammates Process Improvement Participate in the development and execution of project process improvements that help eliminate waste, identify and address inefficiencies, promote flexibility, reduce cycle time, champion change, and promote a simplification mindset Scale project activities to increase the strategic business benefits delivered to our internal/external clients Improve the value of PMO services and influence on business outcomes

Details: Position Description: We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work .(sm) Positions in this function conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. They support short and long term operational/strategic business activities - by developing, enhancing and maintaining operational information and models. They also develop and implement effective/strategic business solutions through research and analysis of data and business processes. Primary Responsibilities: Gathering, documenting and managing business requirements from both customers and internal stakeholders Developing and maintaining functional specification documents Developing and presenting conceptual/functional models and prototypes to users Generating innovative ideas to resolve problems, as well as handling complex issues and negotiating resolutions Communicating with various product stakeholders and customer groups Participating in testing and validation activities Creating and reviewing product documentation Consulting with internal stakeholders throughout the product development lifecycle Creating internal processes that improve work flow efficiency

Details: If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) Position Summary We are seeking a Director of Actuarial Services for our Cypress, CA location responsible for providing actuarial direction and strategy to the actuarial pricing team that supports managed care rate development for a variety of programs. This position will manage, coach and mentor a team of three to four actuaries; lead, design and present actuarial analyses to support the financial and business growth; price products consistent with financial and business objectives; and work with state insurance department on rate filing requirements and secure rate filings approval, include appearing in public rate hearings with the department of insurance as required. The Director, Actuarial Services will also collaborate with other functional teams in a UnitedHealthcare matrix organization in order to provide comprehensive actuarial support to the health plan and keep abreast with the on-going rate regulation (Patient Protection & Affordability Care Act) changes. Obtain gain rate filing approvals from State Department of Insurance on health coverage related products, based on actuarially sound principles and actuarial standard of practices. Negotiate and defend rates on behalf of the insurance company. Articulate the interrelationship between pricing, financial forecasting, reserving, and cost-of-care initiatives in order to provide input into business strategies to grow profitable market share. Manage, lead and develop actuarial staff. Work with other functional areas (i.e., Underwriting, Sales, Legal, and Finance) in an insurance company to achieve business results.

Details: Individual contributor; highly collaborative pooled resource supporting SVP Client Solutions Deployed internally, these high level subject matter experts (SMEs) have expertise across the Optum organization and are brought in to oversee large and complex solution builds internally. This individual works closely with SVP Client Solutions to support solution architecture and development. Engagements will be 40% external, 60% internal. This role requires a hands-on approach with experience in architecting, designing and implementing large scale health management solutions. The ideal candidate will demonstrate a deep product expertise spanning the Optum portfolio, business development mindset and strong relationship management/influencing skills. The Solution Architects engage internally with both the businesses and markets to integrate scalable solutions and ensure implementation and quality assurance based on current industry best practices and leading methodologies. Solution Architects preferably have extensive healthcare experience. They have solid understanding of the markets that we service (entities with medical risk in the payer, provider, employer and government sectors); understanding market demand for products and services to reduce cost and improve quality. They hopefully bring with them a passion for making the healthcare system work better. Primary Responsibilities: Integrates Optum portfolio to design and deliver solutions that holistically address clients' health management needs for strategic, complex, and/or forward-thinking accounts and prospects. Engaged with the businesses and markets in complex solutioning with a focus on driving growth. Primarily responsible for solution based engagement internally and successful relationship management at an Optum level. Develop deep relationships with the business and market contacts responsible for solution builds. Provide strategic insight, solution development and project management on the project's behalf. Understand the organization's unique business environment and challenges, incorporating those into solution development. Consult and collaborate with the market and product leads, applying skills to architect organization wide solutions. Verify we understand the strategic objectives and the initiatives that support the strategy. Partner with both internal and external delivery teams to ensure expectations of service and execution are clearly understood, communicated and met. Provide input to relevant Optum colleagues responsible for solution delivery. Overall accountability for solution delivery. Partner with and support internal and external team to manage expectations and drive successful implementation. Serve as an escalation point for the organization regarding solutioning issues. Conducting diagnosis/ assessment activities and defining high-level program/action plans. Work with product and project teams to analyze and understand enterprise business drivers to determine business information and system architecture requirements. Design and develop solutions that provide clients with secure, robust and scalable solutions, taking into account user requirements, technical requirements, etc. (e.g. solution architecture) and ensuring the architectural integrity of the solutions. Adept at configuring and customizing the products to meet specific client organization type and risk model. Participates and drives all phases of the projects, helping to ensure timely delivery of projects with an emphasis on front-end strategic assessment and solution definition. Partners with Product, RFP team, Pricing, PG, etc. to optimize integrated solution of product offerings. Provides feedback to the product organizations on problem areas and opportunities for increased integration. Provide thought-leadership to internal team members across businesses and technical project dimensions, solving complex business requirements. Mentor all team members on their assigned project tasks. Participate in the development of additional opportunities within the businesses. Collaborates with other solution engineers to provide execution for solution proposals, design and delivery

Details: There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Multiple positions that will be covering Harris county and surrounding areas: Target cities: Houston, Conroe, The Woodlands, Galveston, Pasadena, Channelview This position will be a work at home and out in the field 75% of the time. Primary Responsibilities: This position is responsible for ongoing HEDIS collection and improvement activities at the health plan and reports to the Quality Management Leader Coordinates and performs onsite medical record reviews at provider offices to determine appropriate coding and billing practices, compliance with quality metrics, compliance with service delivery and quality standards, and where assigned investigation of quality of care and member complaints relative to quality of care and service Support continuum of member care by identifying members in need of health education, case management, etc. Educates providers and office staff on proper coding and billing practices, HEDIS and state-mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria Solicit identification of barriers the office faces in providing care to members Supports the HEDIS medical record chase to support optimum HEDIS and quality metric reporting Supports quality improvement program studies requesting records from providers, maintaining databases, and researching to identify members' provider encounter history Participates in and represents plan at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned Performs annual medical record evaluation, follow-up education, practitioner intervention, measurement (QI 13) as required Enter documentation of findings in identified database Generally works independently, under the supervision of the Quality Management leader Participates in or coordinates with other department projects as needed

Details: Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including you. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment. Senior Claims Business Process Analysts are responsible for all related aspects of claim system processes and claim business rules. This includes claims systems utilization, capacity analyses/planning and reporting, claims-related business and systems analysis. Employees in this role ensure data integrity, data security and process optimization. Primary Responsibilities: Responsible for providing research and root cause analysis for claim quality remediation Responsible for all aspects of quality assurance Create and edit requirements, specifications, and recommendations to proposed solutions Facilitate development of process documentation Follow standard programming guidelines and requirements as set by team Standard documentation and tracking processes Uses pertinent data and facts to identify and solve a range of problems within area of expertise Develop and execute test scenarios for all testing efforts including User Acceptance Testing, Regression Testing, End to End Testing and Parallel Testing Actively participate in business level implementation meetings (RSA) Actively participate in SOP creation for manual process Identifies operational impacts and areas for process improvements Identifies and escalates risks related to implementation Post migration support including claims auditing, issue resolution, etc.

Details: Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family. We're also the career home for Nurse Practitioners who bring compassion and passion, energy and focus to their work every day. This is your opportunity to join a group of professionals and clinicians who are working to improve health care for people over 50. Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm) To learn more aspects of this job, click here view the Realistic Job Preview: HouseCalls_Nurse_Practitioners_Optum In this role, you will conduct in-home health assessments on enrolled Medicare Advantage members within a geographic area of responsibility. While the average visit is 45-60 minutes, the nature of the House Calls visit can vary and could include performing an annual health assessment, a post discharge visit, or visiting more complex members more than once per year. Primary Responsibilities: Conduct in-home assessments on health plan members. The House Calls Assessment includes: Past medical history Review of symptoms Physical examination Medication review Depression screening Responsible for checking vitals, conducting a physical exam that includes monofilament test, urine dipstick, and foot exam (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment Formulate a list of current and past medical conditions using clinical knowledge and judgment and the findings of your assessment Communicate findings in your assessment that will be used to inform the PCP of potential gaps in care Educate members on topics such as disease process, medication, and compliance Comply with all HIPAA regulations and maintain security of protected health information (PHI)

Details: You love to challenge the status quo. You thrive on exceeding goals, always making things better than you found them. Bring that passion to UnitedHealth Group and join us on a mission to help people live healthier lives. As a Senior Project Manager, you'll work alongside a high caliber team as you drive innovation and business forward. You'll roll up your sleeves as you coordinate complete projects, defining performance and results. When you get into the driver's seat of this role, you will show your expertise in determining time frames, allotment of staffing and funding resources and leading others in the organization to make meaningful process improvements. This is no small opportunity. As a Senior Project Manager, you'll shift scope definition, risk identification, methodology and resource allocation to a gear you didn't even know you have. You'll take on tough challenges and create innovative solutions. Along the way, you'll grow and develop at a pace that energizes your career while you do your life's best work.(sm) Primary Responsibilities: Coordinate and complete projects, define performance and results and manage vendors and service providers Investigate non-standard requests and problems, makes presentations to senior leadership, ensure project documentation is accurate and ensure projects are completed on time and within scope Review Pertinent data and facts to identify and solve issues and mitigate risks, prioritize your work load and work on ad hoc projects as assigned Partner with the capability team on deployment activities and will have primary accountability for ongoing business process support as it relates to utilization of enterprise tools Manage and lead a group through solution deployment as well as provide guidance and recommendations for utilization of UnitedHealth Group's enterprise, clinical and claim platforms (CareOne, FACETS, ICUE, Etc.) Build knowledge of system enhancements being applied to each application, building year over year Identify and learn processes that will align to the standard or that will remain variant Engage in onsite deployment support to establish relationships with business teams & to develop understanding of key issues surfacing with movement to enterprise tool suite Partner in management of issue resolution during migration go live support Obtain full business ownership of issue resolution post go-live support Drive process alignment; identify ongoing coaching opportunities, process standardization and staffing assessments Act as liaison between business and technology partners

Details: We're OptumHealth, one of the nation's largest health and wellness companies, and a true leader in the health care services and health financing arenas. From behavioral health support and online health coaching, to support for complex medical conditions and more, no other business touches so many lives in such a positive way. At OptumHealth, we're working hard to create a health system greater than anything you've seen or imagined, and you can be part of the solution. We are currently looking for a Director of Clinical Operations to join our team in the Kansas City Metro Market The Director of Clinical Operations will have overall accountability for Program Quality, Internal and External Strategic Partnership and Staff Performance, Retention and Development. Primary Responsibilities: Oversee Revenue Accuracy and Medical Management Develop and routinely update comprehensive medical management work plans and programs Lead the medical expense data analysis to improve outcomes relative to targets and meet budgeted metrics Strategize and implement our clinical model focused on quality, reduced medical cost and incorporating the skills of provider partners Review medical management policies and procedures to ensure compliance with State and Federal regulations along with Evercare clinical protocols Provide oversight and monitoring of clinical documentation and coding initiatives to achieve site revenue accuracy Some travel in the Kansas City area will be required in order to manage field NP's and meet with NH clients

Details: While you're hitting the books, you can be helping to change the world! You have business experience. You're pursuing an advanced degree in business. You want to start making a difference right now. Well, hello and hop aboard. Put yourself among one of the best teams anywhere and start improving your career impact everywhere. UnitedHealthcare is a thriving member of the UnitedHealth Group family of companies. We're doing everything in our power to make health care work better for everyone. That includes the entire spectrum of health care participants: individual consumers and employers, commercial payers and intermediaries, physicians, hospitals, pharmaceutical and medical device manufacturers, and more. Join us in the highly demanding Leadership Development Rotational Program and you'll find yourself working among the most motivated and driven leaders; people who are decisive, brilliant and passionate about creating solutions to help people live healthier lives. You'll have the opportunity for continuous learning while building a foundation of skills that will help create your life's best work.(sm) Our two year Leadership Development Rotational Program (LDRP) is designed specifically for highly talented MBA candidates who are seeking a fast track to an operational leadership role. The LDRP will place you in strategic positions with a dedicated executive sponsor and frequent exposure to multiple leaders, businesses and technologies. You will have the ability to make meaning contributions to the company and help people live healthier lives. Our operations organization consists of over 35,000 employees worldwide that you can impact through your two rotations in different geographic locations. You will gain a broad understanding of our operations while designing and refining operational programs, processes, and projects. Your rotations will give you the opportunity to manage work on top executional priorities including projects that leverage your strategic planning, operations management, critical thinking, and project management skills. You will also be able to flex your leadership knowledge and experience to manage a large operational center ensuring metrics and goals are met and exceeded... and work on some highly visible initiatives such as the deployment of a program improvement project - Consumer Call Accuracy and two new service models: Provider TouchPoint and Advocate4Me. We are excited to have this elite, customized formal development program to fulfill your professional and personal potential. You will have a dedicated executive sponsor as well as the support of operational leaders and human capital partners to leverage as you grow. You will be working with our seasoned operations team to exercise and grow your leadership skills, expand your experience and knowledge, and build a valuable network of peers, managers and leaders across the organization.

Details: You are a thought leader who thrives on developing new solutions to solve tough challenges. As a critical member of our business analysis team, you will help rewrite the future of UnitedHealth Group. Here, your analytical and innovative skills will help us with our mission of helping people live healthier lives. Yes, we share a mission that inspires. And we need your organizational talents and business discipline to help fuel that mission. Are you ready to analyze data and deliver bold, business-savvy ideas to impact the lives of millions? As a Business Analysis Consultant on the Data Services team, you will be empowered to support short and long term operational/strategic business activities; develop, enhance and maintain operational reports that will have an impact on business decisions. In this role, you will have the opportunity to take the contributions of analysts and create valuable solutions to improve the health care system. This person will work in a team of 10 other Business Intelligence Developers and will participate in the full development cycle, from meeting with the end users and gathering requirements to designing, documenting, implementing, deploying and maintaining solutions. Join us! Your passion for performance can fuel your life's best work. (SM) Primary Responsibilities: Meet with end users to gather business requirements Create technical specifications Create clear and intuitive technical and user documentation Develop and support SQL Server Reporting Services reports Design and develop solutions to diverse business requirements

Details: Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM Our Customer Service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care. Employees in this position include those responsible for the administrative intake of members or managing the admission/discharge information post-notification, and working with hospitals and the clinical team. Function includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Also manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. Primary Responsibilities: Under the general direction of the Clinical Director or designee, provide Authorizations for Hospital Admissions, Skilled Nursing facilities, Rehabilitation facilities, Specialist Providers, Outpatient services and Ancillary services such as Home Health Care, Durable Medical equipment, Orthotics/ Prosthetic devices, Colostomy supplies and Infusion services, and others as directed. Assist in the coordination of Discharge Planning activities on all Plan participants. The Plan is dependent upon participants' Discharge needs. Communicate with a variety of Clinical disciplines to clarify and enforce Plan policies and procedures. Collect and review of service requests for completeness and referral to Clinical Director or Medical Director. Answer the telephone ACD line, as scheduled. Verify benefits in Diamond System. Referral filling and distribution to the designee coordinator. Referral processing for Outpatient services, including but not limited to Outpatient Surgeries, Rehabilitation Therapies, Radiation Therapy, Chemotherapy, Provider's evaluations and Follow-up, Ancillary services, such as DME's, HHC and Orthotics/Prosthetic devices. Collection of data for Clinical oversight. Pre-Authorization entering for Requests of services such as Clinical Evaluations/Follow-up visits, Outpatient procedures, Inpatient services such as: Elective Admissions, Emergency Room Admissions, Skilled Nursing facilities, Rehabilitation facilities, Outpatient services, Ancillary services, such as DME's, HHC and Orthotics/ Prosthetic Devices in Diamond System, when applicable. Daily notification to PCP'S of Admissions Authorizations to Acute facilities. Authorization entering for Plan Members under the care of Dialysis and Hospice services. Process Denial Authorizations for non-coverage services for Medicare and Medicaid plan participant's adherence to timeliness for determinations. Maintain and update daily reports as required, including but not limited to: Daily Hospital Admission Census, Skilled Nursing Facility Census, Rehabilitation Census, Part B Census, and Home Health Care Census. Maintain monthly reports for Dialysis, Hospice, Healthy Start, Medicaid Sterilization, Abortion and Hysterectomy, Re-admission to Acute facilities, Admissions to Acute facility and Telephone ACD Reports. Assist Case Managers and PCPs in the coordination of Discharge planning from Acute Facilities to Sub-Acute placements and from Skilled Nursing facilities and Rehabilitation facilities to Home and to Community services. Maintain record of Discharge planning implemented and coordinated services. Send Discharge Notification form with all discharge planning arrangements to PCPs upon discharge from facilities. Follow up with patient to assure accuracy that the coordination of services such as HHC and DMEs has been completed. Consult with various Clinical disciplines regarding specifics patient and their follow-up needs. Identify Risk Management issues following Health Plan guidelines and requirements and submit Incident Reports to Director. Participate in monthly staff meetings. Participate in scheduled In-service for different disciplines. Perform Health Risk Assessment program. Ensure compliance with Risk Management policies and incident reporting. Assist with Health Risk Assessment data verification.

Details: There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Not sure if this role is for you? View the Realistic Job Preview that is focused on the things that matter most to you: Hospice_RN_OptumHealth.pdf We are seeking a knowledgeable, compassionate RN to handle patient visits on a PRN/as needed basis and will be required to travel throughout the West Valley in order to conduct the visits. As a per diem Hospice Nurse, you would work with a team of healthcare providers to ensure our Hospice patients (prognosis of 6 months or less) are receiving the right care. Additionally, you would provide emotional support to the patients' families. This position offers potential for growth, a friendly staff, and an opportunity to interact with patients and their families on a more personal level. Please note: This position is on a Per Diem/PRN basis working as needed. The Per Diem RN will help provide visit coverage for our RN Case Managers who are out of the office. This is a field based position and requires travel throughout the West Valley in order to conduct visits at our patient's home or nursing facilities. Responsibilities for the Hospice Per Diem RN include: (as needed) Conducting visits at home, skilled nursing, long term care and/or assisted living facilities Coordinating, assessing, and implementing patients' care Providing accurate and timely documentation of patient services to reflect plans of care Conducting admissions Interacting with other group members such as CNA's, LPN's, social workers and dieticians Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of biohazard materials

Details: Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum –a growing part of our family of companies that make UnitedHealth Group a Fortune 17 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work . This function is responsible for insurance premium collections. Positions in this function contact customers to determine reason for payment delinquency. Negotiate and advise on collection of overdue bills and take appropriate action to recover overdue payments. Handles unresolved inquiries/issues. Responsible for developing, implementing, maintaining and managing organization policies on collection practices. May work with outside legal counsel and/or outside agencies in more complex collection cases. Primary Responsibilities: Analyzes and investigates. Provides explanations and interpretations within area of expertise.