Ability to work on sensitive subject matter with the highest level of discretion. Review and approve or deny PTO requests as well as track PTO. Responsible for updating the IEX schedules for all PTO including unscheduled absences (Phone Team only) Assist direct Manager/Supervisor in yearly annual reviews. Balance customer assignments within the team to ensure service leve

Ensure quality customer service for internal and external customers with focus on needs identification, problem solving and partnering with billing and eligibility specialists. Monitor delegated customer service issues to ensure timely and accurate resolution. Use appropriate communication techniques when responding to customers, particularly in stressful situations. Plac

Supervises, analyzes, authorizes and directs the work activities for assigned employees Analyzes team performance results by reviewing productivity and quality of work performed by assigned unit Supervises and plans monthly team meetings Meets with individual staff members regularly to assess and align performance goals to ensure staff members are on schedule in attaining

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Supervise Eligibility Representatives in their daily job functions to ensure files are applied timely and all turnaround times and quality standards are met and/or exceeded Telephonically assist our member eligibility or group questions & verify enrollment status Assist the team in meeting production standards Meet and exceed department quality audits and provides coachin

Coordinate and supervise daily/weekly/monthly activities of a 15 person team including setting priorities for the team to ensure task completion and performance goals are met. Coordinate work activities with other supervisors, managers, departments, etc. Identify and resolve operational problems using defined processes, expertise and judgment. Provide coaching, feedback,

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

You'll enjoy the flexibility to telecommute from anywhere within the U.S. 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. In providing consumer oriented health benefit plans to millions of peopl

Apply knowledges / skills to activities that often vary from day to day Demonstrate a moderate level of knowledge and skills in own function Make outbound calls to members who are eligible to participate in one of our Health Management coaching programs Receive inbound calls to enroll members & / or provide customer service Require little assistance with standard and non

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, 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 Co

Work Life Balance/$10,000 Sign-On Bonus/Excellent Benefits/Fortune 5 Company!

Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements Engage with requesting providers as needed in peer to peer discussions Be knowledgeable in

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

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 Co

Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for member transition to community request and provide assist with social service programs, including financial, psychosocial, community and state supportive services Manage the care plan th