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UnitedHealth Group
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  • Executive Protection Specialist - Remote  

    - Hennepin County
    UnitedHealth Group is a health care and well-being company that's dedi... Read More
    UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together. The Executive Protection Specialist ensures the safety, security, and comfort of senior executives, their families, and visiting VIPs through proactive risk assessment, protective operations, and logistical support. The role requires exceptional discretion, integrity, high level physical fitness, and the ability to operate independently in dynamic and high-pressure environments. This role provides a unique opportunity to join a highly skilled team supporting a dynamic and demanding executive protection program. The ideal candidate will bring a balance of tactical expertise, operational efficiency, and a commitment to the highest standards of security. You'll enjoy the flexibility to work remotely 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: Provide a safe and secure environment for senior executives, family members, and visiting dignitaries Conduct advance planning and special event surveys to prepare for executive travel and events Deliver secure, defensive driving for executives during business, personal, and special events Identify and assess potential security threats, providing real-time information to aid decision-making Implement and oversee security and access control procedures at residences, offices, or temporary locations Provide on-site executive protection and logistical support at events and during travel, both domestic and international Act as the central point of communication for security-related incidents and coordinate contingency plans, including emergency medical responses Collaborate with law enforcement agencies and internal/external security partners to ensure seamless protection during operations Monitor and provide feedback on the installation and use of security equipment in sensitive environments Assist with administrative and operational support to enhance executive privacy and convenience Additional Duties Maintain situational awareness of domestic and geopolitical developments impacting security Assist in creating intelligence and briefs for senior management on emerging threats and trends Develop and brief event security plans to executives and support staff Perform research to support risk analysis, due diligence, and threat assessment Provide recommendations to enhance protective services and security measures Participate in training, skillset development, and regular assessments All other duties as assigned 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. Qualifications - External Required Qualifications: 5+ years of experience in executive protection or personal protection experience Valid driver's license with defensive driving experience Ability to travel domestically and internationally, often on short notice (up to 50%) Preferred Qualifications: CPR, AED, and First Aid certifications Current Law Enforcement Officers Safety Act (LEOSA)/HR218 credentials Concealed Carry Weapon (CCW) and Personal Protective Services (PPS) certifications Advanced training in medical emergencies, defensive tactics, evasive driving, and tactical firearms Experience in protective intelligence, physical security, and emergency response Familiarity with residential alarm systems, access control, and surveillance technology Experience in private-sector client service roles Additional Skills and Competencies: Physical and Administrative Requirements Ability to pass pre-employment background investigations, physical fitness evaluations, and drug testing Maintain composure and professionalism during long hours, nights, weekends, and holidays Preferred Attributes Customer-service oriented mindset with solid interpersonal skills Ability to adapt to diverse work environments while maintaining professionalism and attentiveness Proficiency in advance trip planning, including coordination with law enforcement and other security entities Technical Skills Proficiency in using protective communication equipment (e.g., encrypted radios, GPS tracking systems) Familiarity with security technology platforms, such as threat intelligence software and access control systems Ability to produce detailed security assessments, after-action reports, and travel risk analyses Behavioral Competencies Solid situational awareness and ability to make critical decisions under pressure Excellent written and verbal communication skills Ability to maintain confidentiality and discretion in all matters Demonstrated ability to build trust with executives and stakeholders Leadership Read Less
  • At UnitedHealthcare, we're simplifying the health care experience, cre... Read More
    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 This is a Field Based role with a Home-Based office. If you are located in or within commutable driving distance of Waco, TX or surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: 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 Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team 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: Current unrestricted RN license in the state of TX 2+ years of experience working within the community health setting or in a health care role Familiarity with Microsoft Office, including Word, Excel, and Outlook A valid driver's license, reliable transportation and the ability to travel up to 75% within McLennan County, TX and surrounding areas to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices High-speed internet at residence Reside within 50 miles from McClennan County, TX Preferred Qualifications: 1+ years of experience with long term care services and support, Medicaid or Medicare Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations Demonstrated ability to create, edit, save and send documents, spreadsheets and emails *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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. Read Less
  • Associate Director, Event Security - Remote  

    - Hennepin County
    Optum is a global organization that delivers care, aided by technology... Read More
    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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Associate Director of Event Security will assist the Director of Event Security in managing the Event Security Program and ensuring that appropriate levels of security are provided at official UHG events in line with the event security Framework. This role will have responsibilities throughout the full lifecycle of event security risk management. The Associate Director of Event Security plans, coordinates and implements security services and solutions for UHG events. In the absence of the Director of Event Security, the Associate Director will serve as the Director. 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: Management and maintenance of the event security framework Event calendar review and planning General situational monitoring related to ongoing events Execution and/or oversight of event security measures and controls Event-related incident and crisis management support Maintaining the liaison relationship with UHG's Event Center of Excellence, UHG business units hosting events, and third-party vendors of event management services Security related vendor hiring and management Event security-related training, awareness, and communications Defining and assigning events to the Event Security Manager Providing oversight of events assigned to Event Security Mangers 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: Current LEOSA/HR218 or ability to obtain a CCW or PPS certification 10+ years of private sector and/or public sector security experience to include corporate security, intelligence, law enforcement and/or military Direct operational experience in the executive or event security/protective services, or travel security fields Ability to work a flexible schedule and some weekends as needed Ability to travel domestically and internationally, sometimes with short notice Driver's license Preferred Qualifications: Emergency/Protective vehicle operation training or certification Private sector experience in a corporate security Emergency medical experience (EMR/T or paramedic) Knowledge of investigations and protective intelligence best practices Proficiency in MS Office products (e.g., PowerPoint, Word, Teams) Proven ability to apply sound judgement and use discretion when dealing with sensitive and confidential information Proven ability to work effectively during emergency and crisis situations Proven solid verbal and written communication and presentation skills Proven ability to work independently (self-starter) and in team environments Proven ability to engage and maintain solid relationships at all levels of an organization Demonstrated high level of emotional intelligence, situational awareness and flexibility *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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. Read Less
  • **Premium pay offered for evenings, overnights, weekends, and holidays... Read More
    **Premium pay offered for evenings, overnights, weekends, and holidays** 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, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. You have high standards. So do we. Here at UnitedHealth Group, this includes offering an innovative new standard for care management. It goes beyond counseling services and verified referrals to programs integrated across the entire continuum of care. That means you'll have an opportunity to make an impact on a huge scale - as part of an incredible team culture that's defining the future of behavioral health care. For this role you must have an active and unrestricted license in your state of residence and you must be able to work nights, weekends and holidays. Shifts are either Wednesday- Friday 10PM-630AM, Saturday 4PM-1230AM Read Less
  • At UnitedHealthcare, we're simplifying the health care experience, cre... Read More
    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As a Community Health Worker (CHW) , you will act in a liaison role with Medicaid members to ensure appropriate care is accessed as well as to provide home and social assessments and member education. CHW's work in a team-based structure and spend up to 75% of their time in the community engaging directly with members. Interesting in learning to work with medically complex patients who may be experiencing significant addiction and/or behavioral health conditions is important for this role. If you reside in or near Ingham, Eaton Counties , MI or Surrounding Counties , you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Create a positive experience and relationship with the member Keep the member out of the hospital by supporting regular visits to their primary care physician Keep member actively engaged with their primary physician Support the member to ensure pick - up of their Rx Proactively engage the member to manage their care Provide member education Support transitions of care Help to keep members compliant with their care plans Partner with care team (community, providers, internal staff) Knowledge and continued learning of community cultures and values May conduct member assessments if needed What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life and create, copy, edit, send, and save correspondence Microsoft Outlook Ability to travel up to 75% of the time within a 30-to-60-mile radius of home setting Ability to travel within the Lancing, MI area to meet with members Reside in Ingham, Eaton Counties, MI or Surrounding counties Resided within the local community for 2+ years Preferred Qualifications: Bachelor's Degree (or higher) in Social Work and/or Healthcare Administration Certified Nursing Assistant, Home Health Aide or Medical Assistant Community Health Worker (CHW) Accreditation Experience working in Managed Care Previous experience utilizing WebEx Prior Telecommuting experience Field-based experience (such as visiting members' homes) Knowledge of the MI Medicaid and Medicare population Fluency in English and Spanish Ability to create, copy, edit, send, and save spreadsheets using Microsoft Excel *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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 $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED Read Less
  • Field Case Manager - Volusia County, FL  

    - Volusia County
    This is a full-time opportunity - Monday through Friday - 8:00am to 5:... Read More
    This is a full-time opportunity - Monday through Friday - 8:00am to 5:00pm At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together . You push yourself to reach higher and go further. Because for you, it's all about ensuring a positive outcome for our members. In this role, you'll work in the field and coordinate the long-term care needs for patients in the local community. And at every turn, you'll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients. You will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. This is a field-based position based in Volusia County, FL. Primary Responsibilities: 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 Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team 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. 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: Four-year degree plus 2+ years of relevant experience No degree, 6+ years of relevant social service or case management experience 1+ years of experience with MS Office, including Word, Excel, and Outlook Driver's license and access to reliable transportation and the ability to travel within assigned territory to meet with members and providers Preferred Qualifications: LTC Case management experience Experience with electronic charting Experience with arranging community resources Field-based work experience Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Background in managing populations with complex medical or behavioral needs Experience in long-term care, home health, hospice, public health, or assisted living Experience with local behavioral health providers and community support organizations addressing SDOH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.) Bilingual Spanish 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 $23.89 to $42.69 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. Read Less
  • At UnitedHealthcare, we're simplifying the health care experience, cre... Read More
    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 Senior Clinical Program Consultant is part of the Oncology Value Creation team and is responsible for assisting with ideation, feasibility analysis, development/build and implementation of oncology clinical affordability programs. This role will apply understanding of healthcare systems, data analytics, finance/business acumen, oncology practice operations, revenue cycle management, health plan operations and medical benefits to identify opportunities for oncology clinical affordability programs including Utilization Management/Prior Authorization, Oncology Value-Based models, Quality Improvement, etc. You will collaborate with internal stakeholders across United Health Group, United Healthcare, Optum and external stakeholders to ensure projects are aligned with core strategies and goals, implemented and launched on time and in scope. This role will require a methodical and critical thinking mindset with the ability to handle multiple priorities as well as the ability to drive implementation of initiatives and engage organizational partners to execute on comprehensive Value Creation strategy for oncology initiatives. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Create or assist with creation of an overall program/process framework based on research (e.g. purpose, mission, goals, and objectives) Define specific program/process requirements and expectations (e.g., who, what, when, where, why) Evaluate workflows, efficiencies, and best practices to determine program/process specifications Obtain input and feedback from stakeholders during program/process development Identify technology needs to support programs/processes (e.g., systems for use of the program) and provide or coordinate system and reporting requirements) Ensure program compliance with state and federal regulatory requirements; collaborate with regulatory and compliance teams to develop and implement new regulatory and compliance requirements Support multidisciplinary teams in business requirement assessments for new/existing programs, advance enhancements to drive efficiencies, address system deficiencies and/or facilitate corrective actions Coordinate, facilitate and actively participate in operational meetings with internal and external stakeholders; ensure customers, vendors and senior management are provided relevant and timely information on program status, risks and mitigation strategies Collaborate with internal subject matter experts to research ad hoc system and technology-related program issues; identify root cause and implement proactive solutions; Monitor implementation plan against milestones and/or IT release dates to ensure successful delivery of solution 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; Work independently and as a team member 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 Create demonstrated ability to work independently and systematically analyze complex issues, draw relevant conclusions and implement effective solutions Evaluates current business processes to identify re-engineering opportunities; provides support in identifying, developing and implementing process improvements and/or technical capability enhancements Excellent verbal and written communication skills; strong presentation and organization skills as well as the ability to convey complex or technical information in a manner others can understand Adaptable and flexible; contribute innovative ideas to achieve positive results Solid team player/interpersonal skills - ability to influence and work with people of different backgrounds, proven ability to foster teamwork and form alliances with supporting organizations Approaches work with a high sense of accountability and attention to detail - takes ownership of tasks, performance standard and quality results Accuracy and Efficiency - excellent time management and organizational skills, balancing multiple priorities; maintain accuracy when processing detailed tasks while meeting deadlines Self-starter, initiates work independently; able to drive and prioritize work with minimal oversight and demonstrates sound judgment 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: 7+ years of healthcare industry experience with accountability for business results 2+ years of experience working within oncology (clinical oncology practice, oncology practice operations, oncology clinical program development and/or management or oncology value-based care models) Solid experience with data analysis and interpretation; ability to identify errors/anomalies Experience collaborating with supporting organizations within a company Proficiency with Microsoft Office (Excel, Word, PowerPoint) Preferred Qualifications: 3+ years of experience in clinical operations Managed care health plan management experience Experience with UHC business processes and data systems Project management experience Knowledge and/or experience with claims systems and/or reimbursement methodologies Knowledge of, and experience with, process improvement initiatives focused on IT/System enhancements *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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. Read Less
  • Optum is a global organization that delivers care, aided by technology... Read More
    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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Utilization Review Nurse, RN is responsible for providing clinically efficient and effective Inpatient utilization management. Reviews inpatient criteria for acute hospital admissions and concurrent review and or prior authorization requests for appropriate care and setting by following evidence based clinical guidelines, medical necessity criteria and health plan guidelines. Reviews and applies hierarchy of criteria to all inpatient admission and preauthorization requests from providers that require a medical necessity determination. Is involved in assuring that the patient receives high-quality cost-effective care. Uses sound clinical judgement and managed care principles in the coordination of care. Prepares any case that does not meet medical necessity guidelines for medical appropriateness of procedure, service or treatment for review with the Medical Director for a decision. The shift is Monday through Friday 8am-5pm in Pacific or Mountain Time Zone. Occasional participation in weekend rotation is required. If you are located in PST or MST, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Maintains clinical expertise and knowledge of scientific progress in nursing and medical arena and incorporates this information into the clinical review and care coordination processes Performs clinical review for appropriate utilization of medical services by applying appropriate medical necessity criteria guidelines Authorizes healthcare services in compliance with contractual agreements, Health Plan guidelines and appropriate medical necessity criteria Documents clinical reviews in care management system. Provide accurate and timely documentation and supporting rational of decision in care management system Utilizes care management system and resources to track and analyze utilization, variances and trends, patient outcomes and quality indicators Research and prepares clinical information for case review with Physician Leadership for patient treatment and care planning Utilizes knowledge of resources available in the health care system to assist the physician and patient effectively Identifies members who are appropriate for care coordination programs and collaborates with the Medical Management team for care coordination of the member's needs along the continuum of care Successfully completes the Interrater Reliability Testing to ensure consistency of review and application of criteria Meets timeliness standards for decision, notification, and prior authorization activities Serves as an advocate for all providers and their patients Demonstrates a positive attitude and respect for self and others and responds in a courteous manner to all customers, internal and external Maintains the confidentiality of all company procedures, results, and information about patients, contracts, and all other proprietary information regarding Optum business Performs other duties as required or requested in a positive and helpful manner to enable the department to achieve its goals 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: Current unrestricted Registered Nurse (RN) license in state of residence Ability to obtain Registered Nurse license in the state of California within 90 days of hire 3+ years clinical nursing experience in acute care hospital or LTAC setting 1+ years Utilization Management experience in hospital or insurance setting Experience applying Medicare and/or Medicaid guidelines Experience with Milliman (MCG) or InterQual guidelines Experience researching and preparing clinical information for case review with Physician Leadership for patient treatment and care planning Experience providing accurate and timely documentation of clinical review and supporting rational of decision in care management systems Experience employing analytical skills necessary for quality case management, utilization review, and quality improvement to meet organizational objectives Experience using various computer software applications with an intermediate level of competence, including Microsoft Word and Excel Primary residence in Pacific or Mountain time zone and ability to work required hours in PST or MST Preferred Qualifications: Inpatient Utilization Management experience Utilization Management experience for insurance or managed care organization Prior Authorization experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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 $60,200 to $107,400 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. Read Less
  • At UnitedHealthcare, we're simplifying the health care experience, cre... Read More
    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. Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. As part of a care management team who will manage a caseload of complex members, the Clinical Care Coordinator will be the primary care manager for members with complex 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. This is a home-based position in SE Colorado with field responsibilities approximately 25% of the time. Primary Responsibilities: Engage members and/or their families face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs 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 Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan 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.) Work with community partners and stakeholders to provide comprehensive support for members with complex needs 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: Must meet one of the following: Current, unrestricted independent licensure as a Social Worker 4-Year or Higher degree in a behavioral health related field (e.g., psychology, counseling, etc.) plus 3+ years of direct experience LPN with 5+ years of direct experience 2+ years of experience working within the community health setting or in a health care role 1+ year of experience with local health providers and/or community support organizations addressing the SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing / rapid re-housing assistance, etc. 1+ years of experience with MS Office, including Word, Excel, and Outlook Resident of Colorado Driver's License and access to reliable transportation Preferred Qualifications: Demonstrated experience / additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care Experience working in team-based care Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Bilingual in Spanish or other language specific to market populations Background in Managed Care 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 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. Read Less
  • Optum is a global organization that delivers care, aided by technology... Read More
    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, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together . The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field 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: MD or DO with an active, unrestricted medical license Obtain additional licenses as needed Current Board Certification in an ABMS or AOBMS specialty in Oncology 5+ years of clinical practice experience (inclusive of Medical Oncology) Experience working with NCCN guidelines Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review Participate in rotational holiday and call coverage Preferred Qualification: Experience in managed care and quality management *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $238,000 to $357,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 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. Read Less

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Astrid-Lindgren-Weg 12 38229 Salzgitter Germany