Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

Acts as primary CAHPS Manager Collaborating with leadership, develop and drive tactical plan that can be leveraged across the enterprise to achieve CAHPS goals Manages vendor relationships to support CAHPS program Analyzes key KPI's and data to derive progress and opportunities for improvement Establishes and reviews performance metrics on a regular basis to ensure effort

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

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

Build multi channel automated and batched campaigns in Salesforce Marketing Cloud Journeys that deliver on campaign objectives Manager campaign production schedule in Asana, and ensure launch deadlines are met and communicated internally Conduct routine reporting on assigned email campaigns to ensure optimal performance Design marketing experiments and employ A/B testing

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

Secure, track and review records via multiple media Identify program specific documents within member's records Submit coverage checks and claims to Allstate on members behalf Use clinical judgement to prepare records for external review Use clinical judgement to triage patients for program candidacy Make appropriate referrals into various programs in a timely manner Act

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

Make outbound calls and receive inbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condit

Provide quality reporting and analytics to support the end to end Super Hero program Partner with the program director to determine the nomination and selection strategy and gain key stakeholder support. Identify process improvements and develop solutions to streamline and scale the nomination and selection process Lead the nomination and selection process including Devel

Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership Provide expertise and customer service support to members, customers, and / or providers Identify and resolves operational problems using defined processes, expertise, and judgment Investigate claim and / or customer service

Serve as a coding resource and provide coding expertise and guidance for IFP Product and configuration partners Develop and maintain code sets used to define IFP medical and specialty benefits (hearing, vision, dental), seeking and promoting enterprise alignment when appropriate In partnership with Product and Clinical partners, ensure IFP sources of truth for benefit adm

Investigations Refine investigation protocols, documentation standards, and policy interpretation guidelines in partnership with Employment Law and ER Case Management leadership Conduct thorough, timely, objective, efficient and equitable investigations into employee complaints and allegations of misconduct, in line with agreed upon investigation framework and applicable

Graphic Design Develop compelling static graphics, infographics, and other visual content that meet business goals across print materials and digital channels Motion Design Utilize your exceptional storytelling abilities to conceptualize and develop narrative driven short and long form videos for a variety of digital platforms including web, social media, and internal com

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 Com