Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating, and resolving all types of appeals and grievances Communicates with appropriate parties regarding appeals and grievance issues, implications, and decisions Analyzes and identifies trends for all appeals and grievances May re

Create/maintain calendars/coordinate meetings avoiding scheduling conflicts Create/prepare meeting materials (e.g., PowerPoint deck; agendas) and ensure distribution to appropriate individuals in a timely manner Schedule, coordinate, and/or set up resources and technology (e.g., conference rooms; food; WebEx; Telepresence) needed for meetings/events (e.g., training) Make

Conduct assessments in a variety of settings on health plan members, including past medical history, review of symptoms, physical examination, medication review and depression screening Responsible for checking vitals, conducting a physical exam that includes monofilament test and foot exam (as appropriate) Identify diagnoses to be used in care management and active medic

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Provide support and strategic counsel on a wide variety of matters including, regulatory compliance and oversight, contracts, STARs, the Inflation Reduction Act, and finance Collaborate with colleagues across the legal, compliance, and regulatory affairs departments You'll be rewarded and recognized for your performance in an environment that will challenge you and give y

Develops and executes strategies for a function or discipline that span a large business unit or multiple markets/sites Research and develop applicable business rules that support product reimbursement methodologies and policies for existing and new business opportunities (e.g., Medicare; Medicaid; commercial) Support ongoing maintenance of pay as state pay facility prici

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

Act as internal counsel on the No Surprises Act and its rulemaking Act as internal counsel on state law regarding out of network reimbursement Act as internal counsel on preemption issues associated with the No Surprise Act and out of network reimbursement Provide internal counsel across the organization on out of network reimbursement Provide internal counsel on the reso

Assesses and interprets customer needs and requirements Identifies solutions to non standard requests and problems Solves moderately complex problems and/or conducts moderately complex analyses Works with minimal guidance; seeks guidance on only the most complex tasks Translates concepts into practice Provides explanations and information to others on difficult issues Coa

of Job To lead a team of case managers, while overseeing day to day clinical operations and participating in business development activities. The person in this position will manage a program or region, including performance management, process improvement, and standardized execution of clinical decision processes, case manager team management and implementation of new pro

Preparing and assessing financial, qualitative and valuation analyses Lead special initiatives for corporate senior executives Key liaison to business segment senior leadership, transaction advisors and acquisition targets Developing and coaching junior team members (training, coaching, and mentoring) Defining and negotiating transaction terms Leading and conducting due d

Manage the production and documentation of multiple high version daily and monthly direct mail campaigns, working with cross functional areas to ensure all aspects of program requirements are met Ability to write complex vendor programming instructions Serve as the central point of contact for the business line, understanding the implications of changes and the requiremen

Responsible for strategically enhancing and maintaining site security and emergency response protocols across assigned UHG campuses, ensuring the continual application of consistent security measures and policies Fostering a visible, in person presence to cultivate trust and accessibility among all levels of personnel, from frontline employees to top executives, ensuring

Responsible for strategically enhancing and maintaining site security and emergency response protocols across assigned UHG campuses, ensuring the continual application of consistent security measures and policies Fostering a visible, in person presence to cultivate trust and accessibility among all levels of personnel, from frontline employees to top executives, ensuring

Coordinates the UHC to UMR RFP migration requests Reviews ASA, SPD, SBC's Provides support to assigned Sales Office to minimize the administrative work of SAE's & FAM's Report requests for Stewardship/Annual Review Meetings with customers/brokers Scheduling customer/broker reports on InfoPort Creating standard presentation templates as needed Conducts and/or coordinates n