Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate, lease restrictive level of care. Identify and initiate referrals for member transition to community request and provide assist with social service programs, including financial, psychosocial, community and state supportive services. Manage the care plan

Participates and assists in the preparation of quality committees, performance improvement projects, and other aspects of the Quality Assessment and Performance Improvement (QAPI) program as assigned Collect information based on applicable standards, state/federal or other regulations, internal requests, or project assignments Leverages available resources to improve qual

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

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. Conne

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. Conne

Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem t

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

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Sort and file patient demographic forms (may include lifting up to 30 lbs.) Locate and retrieve patient demographic forms when requested. Cross train and work in all processes when needed Other duties as assigned Repetitive movements including sit, stand, kneel, reach You'll be rewarded and recognized for your performance in an environment that will challenge you and give

Assess, plan, and implement care strategies that are individualized by the member and directed toward the most appropriate, lease restrictive level of care Utilize both company and community based resources to establish a safe and effective case management plan for members Collaborate with patient, family, and healthcare providers Identify and initiate referrals for socia

Responsible for conducting telephonic or face to face holistic evaluations of Member's individual dynamic needs and preferences gathering relevant data and obtaining further information from Member/family identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services, and long term services and sup

Visit members in the hospital prior to discharge Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels Assist members with the transition from a care facility back to th

Make calls to qualified members to provide information and answer questions about health plan programs. Provide "best in class" customer service to enrollees Meet established productivity, schedule adherence, and quality standards while maintaining good attendance. Identify, qualify, and engage members into the most appropriate health and wellness programs to meet their n

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

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