Conduct financial and network pricing modeling, analysis and reporting Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies Lead projects to completion by contributing to database creation, statistical modeling and financial reports Concisely summarize and communicate the results of complex an

Make Extra Money/Fortune 5 Company/Friendly Work Environment!

Develop, lead and execute category management strategies, conduct sourcing / RFX events, manage suppliers and conduct financial analysis Primary responsibilities surround Pharmaceutical Draft, Review, and lead negotiations of third party supplier contracts, including Master Services Agreements (MSAs), Statements of Work (SOWs), Non Disclosure Agreements (NDAs) and amendme

Intake/screening/referral, assessment/reassessment, development of support plans, on going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department prescribed system, resource development, and case closure Respect confidentiality and maintain confidences as described in the UHG Employee Hand

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 Document and track member engagement You'll be rewarded and recognized for your per

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Growth Define, develop and implement a data driven, locally focused membership growth strategy for the DC health plan. This includes areas/skills such as Strategic thinking and planning, including project management Market research and analysis Sponsorship and budget planning and management Collaboration with national and health plan teams Community Engagement Thoughtfull

Identify potential health care business customers Develop business relationships with agents and/or brokers to increase sales Promote sales of health care and ancillary products to Mid Market Employers through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendations on whic

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Ensuring delivery of cost effective quality care that incorporates recovery, resiliency and person centered services Responsible for Level of Care guidelines and utilization management protocols Responsible for oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management, and care coordination activities Provide

Identifies opportunities for specialty/enterprise products on all new sales Negotiate with underwriting when necessary Understand and effectively selling multiple products, requiring knowledge of Health Care Reform guidelines and how they differ between level funded and specialty products Develop and maintain solid broker/consultant relationships Properly setting broker a

Telecommute position/Fortune 5/Excellent Benefits!

Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prior to physician's/nurse practitioner's examination, serv

Work Life Balance/$15,000 Sign-On Bonus/Fortune 5 Company/Excellent Benefit Package!

Build and maintain solid relationships with key brokers and others as necessary within the assigned territory Develops action plans and strategies to optimize Medicare sales Partner with the Community Developer (CD) and Sales Director (SD) to identify and develop relationships with individuals and organizations that influence the buying behavior of our target consumer (e.