Synthesize and forecast industry trends, customer needs, competitive threats, survey insights, member experience best practices and internal and competitive performance to design industry leading customer service and health plan improvement strategies Serve as a subject matter expert in CAHPS measure specifications, member pain points, survey strategy and business operati

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Collaborate cross organizationally in the development, proposing and prioritization of customer solutions to reduce trend (programs, processes, benefit design, network, etc.) Works with business partners to ensure are aligned with successfully achieving savings targets Development and execution of cross functional strategies, projects and tactics which result in increment

Strategic Planning In partnership with key stakeholders across marketing, oversees the strategic planning, budget and execution of industry programs and trade shows Trade show SME Support team and partner across marketing and sales stakeholders by being the subject matter expert on trade shows, enabling capabilities, proactively meeting their needs, communicating effectiv

Promote Excelsior's product portfolio to benefits brokers and help them increase their enrollment and average case size with all product lines Ability to negotiate and close sales Conduct in depth market presentations for brokers and employers Create and drive strategies for top producing agencies and Brokers Collaborate with Sales Management regarding pipeline, persisten

Make determinations of medical necessity/clinical appropriateness of treatment Assist in the development and implementation of clinical policy, guidelines and applications Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community Be knowledgeable on and apply all necessary regulatory requirements for assigned re

Own the creation, prioritization, and delivery of the intranet roadmap in alignment with stakeholder and company needs with a specific focus on delivering a great audience experience Review user requirements, ask questions and provide suggestions when needed Frequently interact with cross functional teams including our internal/ external/ digital/ people/finance/communica

Financial management of the UnitedHealthcare and UHG Global real estate portfolios Includes all day to day financial support both Operations costs and Capital costs for those portfolios month end, forecast, financial analysis, project tracking, etc. Customer relationship management (CRM) coordinate & lead review meetings; recommend and establish strategies, plans, and pro

Part of a team of dedicated actuaries and data scientists to study the usage of ML based algorithms applied to historical pharmacy, inpatient notification data, prior authorization data and ultimate utilization and claims data to identify predictive capabilities that can enhance UHC's current trend forecasting models Work with the operational team to identify opportunitie

Part of a team of dedicated actuaries and data scientists to study the usage of ML based algorithms applied to historical pharmacy, inpatient notification data, prior authorization data and ultimate utilization and claims data to identify predictive capabilities that can enhance UHC's current trend forecasting models Work with the operational team to identify opportunitie

Predicts emerging customer (state, health plan and functional partner) needs and develops innovative solutions to meet them Solves unique and complex problems with broad impact on the business Participates in the development of business strategy Develops and manages business plans to achieve objectives Leads large, complex projects related to policy, advocacy and influenc

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,

Manages ongoing relationships and service delivery to clients for one or more accounts Acts as outward facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and large or complex accounts Works closely with Sales Leads on renewals and upselling, but incumbents do not have specific sales goal accountability or primary respo