admin Resp & Qualifications PURPOSE: The Inpatient Management Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both care management and utilization management including proficiency in established guidelines to determine medical necessity, appropriate level of care, and case management to engage … Read more
Resp & Qualifications PURPOSE: Under minimal supervision, the Care Manager researches and analyzes a member’s medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to optimal health and … Read more
Job Responsibilities • Providing clinical expertise in the development of programs and educational material pertaining to clinical management; providing guidance to staff who work directly on the programs. • Developing and implementing clinical programs to achieve improved rates, the highest accreditation, and improvement in the health of the population… • Managing a team(s) of clinical … Read more
pWhy should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades wersquo;ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but wersquo;re stronger than ever. Our A.M. Best … Read more
Resp & Qualifications PURPOSE… Provide a range of communications support from strategic communications planning to execution, including planning events, developing marketing campaigns for those events, and leading other client communications initiatives, including outreach campaigns to drive acceptance of policies and . Draft and edit a variety of communications materials and products, including talking points, leadership … Read more
Resp & Qualifications PURPOSE… The Technician, Enrollment I is responsible for ensuring that members are accurately enrolled into CareFirst member enrollment systems in a timely manner, and according to the account contract or service agreement. To accomplish this, the associate in this role may interact and coordinate activity with key client account contacts, subscribers, CareFirst … Read more
Resp & Qualifications PURPOSE: Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic… technical assistance and troubleshooting … 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 … 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 … Read more
If you are located within Central Time Zone, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. UMR, UnitedHealthcare’s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It’s that simple . . . and it’s that rewarding… … Read more