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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Sales Support

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

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Senior Account Manager, Client Services- Telecommute

UHG - US

Posted: 11/12/2018

The Clinical Program Consultant (CPC) represents Case Management services to designated group representatives by providing follow up on issues and inquiries, report outs on high cost or other claimants and is a liaison to the operations teams.  The CPC proactively identifies and communicates client level trends and opportunities to improve quality, efficiency and program effectiveness.
 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

  • For selected clients, perform regularly scheduled clinical analytical review
    • Provide  clinical updates on selected cases to include project medical spend trending and care opportunities
    • Evaluate variances to, or achievement of, committed metrics consistent with product definitions and performance guarantees
    • Evaluate client level medical cost and utilization trends
    • Identify program opportunities
    • Collaborate with CMC team to make recommendations with defined value to support client population needs
  • Attend client meetings as requested; Commonly for the purpose of delivering the OptumHealth/UMR value story as part of client level performance and outcomes reporting or finalist meetings

  • Provide assistance in preparing for all client and external audits

    • Represent OptumHealth Care Solutions during audits for all program/product questions, operational delivery enhancements, and future planned solutions to identified gaps

    • Post audit, contribute to the documentation of issue resolution steps and work with responsible teams to ensure steps are implemented
  • Monitor key performance indicators for all groups supported, maintaining a client status indicator
    • For those where the program performance metrics are not being met, ensure corrective action plans are developed, implemented, and communicated to appropriate stakeholders
  • Other responsibilities, as assigned

Required Qualifications:

  • RN licensure with 5+ years of experience in a managed care environment
  • 5+ years of experience in operational, problem solving, process development, and consensus building roles in a direct or indirect managed care environment, including multi-functional departments
  • 3+ years of external client facing or customer facing experience
  • 3+ years proven analytics background (gathering data reports, analysis of data, identification of changes, creation of action steps based upon findings)

Preferred Qualifications:

  • Previous clinical product operations experience in utilization management, case management, disease management, or discharge planning
  • Knowledge of clinical program design, implementation, management/monitoring
  • Data analysis capabilities with strong drive to synthesize the story into an actionable set of recommendations
  • Client facing abilities; Ability to translate product and operational design and complex medical situations to non-clinical terms for client understanding
  • Ability to translate client business objectives and expectations to scalable sustainable solutions

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

 

 

Job keywords: nurse, RN, case manager, telecommute, remote

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