Supervisor, Preservice Review Nurse - Remote
Phoenix, AZ
Manages and evaluates direct reports of UM Prior Authorization Nurses, Inpatient Care Managers, Clinical Coordinators, and other team associates Manages the compliance for UM to meet est...

Primary Care Physician - Primary Care Plus - Gonzales, LA
Gonzales, LA
Assisting in the development of the plan of care in addition to providing appropriate patient/ family/significant other counseling and education Ordering and interpreting appropriate lab...

Sr. Disability & Leave Analyst - Remote
Minnetonka, MN
Collaborate with internal partners, such as Environmental and Enterprise Occupational Health and Safety, Accessibility COE, Real Estate Services, Talent Acquisition and Employment Law to...

RN Nurse Reviewer
Eden Prairie, MN
Utilize the Preferred One medical criteria and those of other regulatory bodies, (i.e. NCQA, DOH), the exempt and focused review programs, and the patient's benefit plan summary to perfo...

Customer Service Advocate - San Antonio, TX
San Antonio, TX
Respond to and resolve, on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims,...

Telephonic Nurse Case Manager RN - Cheektowaga, NY
Cheektowaga, NY
Make outbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Interact with Medical D...

Sr Director Real Estate Services Delivery, Program Management - Remote
Minnetonka, MN
Chair a recurring workgroup that connects all Real Estate Delivery Integrated and Non Integrated Entity real estate leadership teams (all functions) together to facilitate best practice...

Preservice Review Nurse - Las Vegas, NV - Remote
Las Vegas, NV
Evaluate and assess each request verifying eligibility and specific product Determine benefit level based on site of service Utilize written criteria to approve, pend or send the case to...

Member Liaison Coordinator, ALTCS EPD - Hybrid Phoenix, AZ
Phoenix, AZ
Hybrid role available in office and virtually as scheduled to support ALTCS EPD members, families, providers, and internal and external stakeholders when needed Provide advocacy and syst...

Preservice Review Nurse RN - Remote
Phoenix, AZ
Perform initial and ongoing reviews pertaining to primary role (PA, ICM, DCM, PACM), appropriately applying clinical criteria (InterQual, policies, National and Local Coverage Determinat...

Lead Pharmacist PA Appeals - Virtual
Sugar Land, TX
Support primary team manager and director with all tasks related to appeal review Serve as a subject matter expert (SME) for benefit management and appeal cases review including job aids...

Benefits Compliance Consultant - Hybrid in Minnetonka, MN
Minnetonka, MN
Responsible for regulatory compliance oversight for the qualified and nonqualified plans of UnitedHealth Group and their affiliated entities (the "Plans"), which includes compliance test...

Underwriter - National Remote
Fort Worth, TX
Assess Medical Risk for the Company Review/Analyze Evidence of Insurability and determine appropriate course of action (e.g., request requirements, approve, rate, decline) Review/Analyze...

Field Account Manager, Key Accounts- Denver, CO
Denver, CO
The KA Field Account Manager is accountable for the field based service of small to mid size, standard/non standard customers under 1,000 members. In this position, the KA Field Account...

Manager - Clinical Care Coordination - ALTCS - Cochise / Graham / Greenlee Count
Sierra Vista, AZ
of Job To lead a team of case managers, while overseeing day to day clinical operations and participating in business development activities. The person in this position will manage a pro...