Serve as business counsel for the Optum Technology organization Provide legal support for transactional matters, such as software licenses, cloud computing arrangements, collaboration and joint development agreements, supply agreements, equipment purchase and lease agreements, mobile app development agreements, offshore sourcing arrangements, and IT services agreements Ne

Develops functional, market level, financial plans, and/or organizational priorities Lead large, complex projects to achieve key business objectives Provides leadership to and is accountable for the performance of senior level professional staff, developing future leaders for the organization Impact of work is most often at market level Direct work that impacts commercial

Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) Analyze payment appendices to provide options for various contracting approaches and methodologies Communicate results of financial impact and analysis to appropriate st

Provide day to day paralegal and legal services support including leading or assisting on special projects from the Legal Team Work closely with Legal, Quality Management and Regulatory Affairs (QMRA), Compliance and other cross business and functional stakeholders on activities related to enterprise wide regulatory and quality management systems, including coordination,

Deliver technical immigration case consultations, provide guidance and education on GMIT best practices and policies to internal stakeholders Provide consultative guidance including assessing visa eligibility. Partner with immigration counsel to provide immediate and long term strategic case recommendations Partner with managers, talent acquisition, people business partne

Advise UnitedHealthcare's Medicare Part D business Counsel on Part D product, clinical (Pharmaceutical & Therapeutic Committee, formulary development), marketing, and regulatory requirements Provide strategic counsel to the business on the Pharmacy Benefit Management (PBM) Agreements, benefit implementation and management, and compliance oversight and monitoring Provide c

Confirm contract compliance requirements to meet the needs of Turquoise Care contract network standards Possess knowledge of Managed Care Organization (MCO) contracting/credentialing process Experience working with providers/facilities in order to conduct advocacy initiatives with targeted providers to solicit participation Work with cross functional teams within UnitedHe

Apply clinical knowledge to Case Managers behavioral health reviews to enrollee's identified as needing or receiving behavioral health services Conduct behavioral health consults with Case Managers, daily and maintain a quarterly schedule for identified members needing or receiving behavioral health services Serve as member advocate by addressing stigma, following Guiding

Test Data Provision & Masking Operation Test data need & masking analysis ( Data structure, SQL queries) Working with Informatica tool to configure & invoke Data Copy and Masking jobs and maintain Gold Copy Maintenance of TDM Portal using UNIX scripting, Java Spring boot and Angular You'll be rewarded and recognized for your performance in an environment that will challen

Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem t

Lead IS TDM customer operations for test data fulfillment Create features for data masking, self service, subsetting Support TDM technology advancement to advance TDM goals Coordinate with vendor team at offshore Lead TDM documentation initiatives on SOP, run books etc. Researches security trends, emerging threats and incorporates design and build solutions, policies, and

Assists in documenting standard operating procedures and business rules for the department Communicates with superiors, peers, employees, internal and external customers, and others, as appropriate, on a regular basis, assuring proper flow of information Assists in resolving problems relating to all areas of Patient/Third Party billings and missing information Responds to

Full oversight of the specialty sale to achieve health plan market sales goals and maintain profitability Advocate for specialty voluntary products to support increase in enrollment and size of sale and negotiate based on broker/customer feedback with underwriting; leveraging rate bank, product discount programs and packaged savings to leverage the best value to the custo

Review, validate and maintain financial and other records as they relate to client specific programs for Taft Hartley Fund Responsible for timely reconciliation of all accounts Process payments and retrieve required statements from websites Communicate financial discrepancies and resolve Responsible for all financial exchanges related to participant accounts Identify erro

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 Com