Make outbound dialer and manual calls to members in regard to cancer support services Take inbound calls from members regarding cancer support services Determine if the consumers are eligible for a health program Schedule initial appointments with a nurse Must have accurate documentation Must meet monthly metrics Other duties as assigned You'll be rewarded and recognized

Support case and disease management teams to achieve optimal clinical outcomes for high risk populations Proficient in evidence based clinical guidelines and lead grand round clinical education sessions with nursing teams Primary functions include RN case manager support and consultation about high risk members and assisting in account management team presentations Be inv

Set strategy for experience improvement that supports FP member NPS and retention goals Establish a culture focused on our people obsessed with continual improvements to our members' experience Present strategy to senior management and measure against the strategy Identify, develop, and support the implementation of operational process changes & innovative solutions that

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

Assist Managers and Supervisors with escalated issues Assist in development of training materials; acts as Subject Matter Expert Fields questions and serves as a resource for Clinicians and non clinicians Reviews and updates job aids to maximize quality and productivity Trend, analyze and improve processes and suggests improvements Participate in quality improvement initi

Perform utilization review determinations for radiation oncology populations, and support case and disease management teams to achieve optimal clinical outcomes Speak with providers by phone. This will include discussion of evidence based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense Enhance c

Responsible for managing an average caseload of 45 50 Medicaid members; mostly adult members Responsible for performing assessments to determine members needs, develop care plans, provide education and community resources along with advocating for each member Perform field visits either in the home or long term facility as needed Address social determinants and ensure tha

Engage directly with care providers, physicians, and office staff via phone calls and faxes Document provider feedback and consult with senior clinical pharmacists if there are questions about treatment, drug efficacy, or authorization status Shadow UHC pharmacists to gain a better understanding of the various roles they have within the UHCP team Collaborate with analytic

Utilize advanced clinical skills to engage and motivate Consumers via a recovery, health and wellness oriented approach Assist consumers and their families/caregivers with connections to appropriate psychiatric, medical, and psychosocial referrals and services Identify and remove barriers to procurement, delivery, participation in and success of services Provide supportiv

improving the quality, cost, and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind. The Nursing Internship Program is full time, 40 hours

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

Successfully become licensed in health & life within your resident state within first 30 days of Co op, if not already licensed Mainly handling inbound calling, NO knocking on doors Answer incoming phone calls from prospective members and identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and ultimate

Respond to client inquiries and concerns ensuring timely service delivery of excellent customer satisfaction Create and assign work orders to multiple technicians, subcontractors, and/or vendors Effectively communicate work order details with technicians, subcontractors, and/or vendors, and effectively provide up to date reports on work order statuses Experience working w

Make outbound calls for the purpose of confirming and rescheduling appointments according to protocol and other special projects Answer telephone, record and direct messages appropriately in the EMR, and screen and direct calls Enter patient data in the EMR and create global alerts in the EMR to ensure all needed demographics, HIPAA Privacy Notice Acknowledgements, Advanc

Educate members on health education and condition management (formal and informal), as well as plan specifics and member resources, in collaboration with OptumHealth Referral of employees to available clinical programs including premium designated physicians Create, manage and implement employer specific programs based on employer needs Monitors and analyzes customer spec