Assess, plan, implement, coordinate, monitor, and evaluate case management activities for offenders being released from state and local prison and for those currently residing at the Community Transition Center, across the continuum of care, within the scope of the case manager's license Coordination and service delivery, Physical and psychological factors, Case managemen

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

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

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

Establish a trusting relationship with youth and family Keep youth and family actively engaged in the planning and implementation of their wraparound care Identifies and build on strengths and culture of youth, family, and support system to create individualized and integrated care plan Collaborate with youth and family's identified support team (community, providers, int

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

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

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Utilize the NYS UAS Assessment as needed in the home or via telehealth to develop a person center service plan to meet the member's needs Identify and initiate referrals for social service programs, including financial, p

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Growth Define, develop and implement a data driven, locally focused membership growth strategy for the DC health plan. This includes areas/skills such as Strategic thinking and planning, including project management Market research and analysis Sponsorship and budget planning and management Collaboration with national and health plan teams Community Engagement Thoughtfull

The KA Field Account Manager is accountable for client and member education as well as escalated service issues of small to mid size, standard/non standard customers. In this position, the KA Field Account Manager is responsible for the following Coordinates, staffs, and conducts open enrollment meetings, wellness fairs and lunch and learns Acts as a strategic partner and

Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff Work most often impacts a large business unit, or multiple markets/sites You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succe

Address any escalated issues sent to them, the SAE, or other field employee Work with the central team and their manager to coordinate resolution Meet with customers quarterly (or more often if requested) to review service related statistics including ideas for improving or enhancing the customer's total service Conduct training/education with customers on UHC eServices,

Perform initial and concurrent review of inpatient cases applying evidenced based criteria (InterQual criteria) Discuss cases with facility healthcare professionals to obtain plans of care Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation in discussions with the Clinical Services team to improve the pr

Collaborates with the University Bursar, Registrar, IT Services and Web Services departments to ensure smooth processes throughout the insurance plan year. Coordinates the administrative aspects of a competitive bid process for USHIP and the optional insurance plans. Maintains the University Student Health Insurance Administration Tool, which tracks students' annual enrol