Manage end to end conference/event related planning that drive a consistent attendee experience, providing on site support when needed Develop, streamline, and create best practices, processes, and reporting, keeping the business goals and policies in alignment Review and manage relationships with existing and potential vendors, ensuring mature utilization of existing too

Translate business rules and business requirements into system level requirements as part of user story refinement, documenting and communicating system changes Generates requirement documents that communicate process workflows and functional needs to both business stakeholders and technical staff. Maintains expertise and understanding of existing system functionality to

Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to derive competitive financial responses Meets quarterly reporting requirements Anticipates customer needs and proactively develops solutions to meet them Serves as a key resource on complex a

Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to derive competitive financial responses Meets quarterly reporting requirements Anticipates customer needs and proactively develops solutions to meet them Serves as a key resource on complex a

Perform telephonic outreach to improve health quality outcomes Optimize pharmacy therapy through additional telephonic engagement with providers and pharmacies Oversee pharmacy projects from inception to completion Provide responses to drug information requests Assess and interpret customer needs and requirements Identify solutions to non standard requests and problems Co

Acts as resource to members calling into a customer service setting addressing medical/health questions Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow up with the member Provide process and status on previously submitted prior authorizations or pre determination requests Effectively refers and enrolls memb

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Investigate medium to highly complex cases of fraud, waste and abuse Detect fraudulent activity by members, providers, employees and other parties against the Company Develop and deploy the most effective and efficient investigative strategy for each investigation Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tr

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Com

Make outbound calls and receive inbound calls to assess members current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with conditi

Manage end to end conference/event related planning that drive a consistent attendee experience, providing on site support when needed Manage relationships with existing and potential vendors, ensuring mature utilization of existing tools and roadmap development Provide ongoing work direction to Attendee Managers regarding registration, reporting, attendee communications

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Co

Provide advocacy and system navigation of behavioral health services and social services and supports Build partnerships with individuals, families, youth, and key stakeholders to promote recovery, resiliency, and wellness Oversee the provision of, and ensure the availability of, Peer Support services by having access to reports to monitor, track, and trend these services

Perform telephonic customer outreach to improve health quality outcomes in collaboration with clinical pharmacists Provide additional telephonic engagement with providers and pharmacies Assess and interpret customer needs and requirements, triaging to a clinical pharmacist when appropriate Outbound calls to CAHPs detractors and MedAdhmembers to improve member experience a

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, c