Analyze financial protection products to assess risk, prepare financial modeling for client strategies, and manage business renewals focusing on profitability while delivering competitive proposals to support growth.

Title: Prepay Coding Consultant Location: Plymouth United States Job Description: Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time, Monday - Friday. Employees are required to work our normal business. It may be necessary, given business need, to work occasionally overtime or weekends. We offer weeks of paid on-the-job training. The hours during training will be 8:00am to 5:00pm CST, Monday - Friday. Training will be conducted virtually from your home. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules and guidelines - Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes - Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes - Utilize medical coding software programs or reference materials to identify appropriate codes - Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations - Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters) - Provide information or respond to questions from medical coding quality audits - Educate and mentor others to improve medical coding quality - Demonstrate basic knowledge of the impact of coding decisions on revenue cycle - Attain and/or maintain relevant professional certifications and continuing education seminars as required - All other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma/GED - Certified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA - 3+ years of CPT & ICD coding experience (surgical, hospital, clinic settings) - Intermediate level of proficiency with PC based software - Ability to work our normal business hours of 8:00am - 5:00pm, Monday - Friday. It may be necessary, given the business need, to work occasionally overtime or weekends - Must be 18 years of age OR older Preferred Qualifications: - AHFI or CFE certification - Licensed Registered Nurse (RN) - Licensed Practical Nurse (LPN) - Experience in a production environment - Experience with one or more of the following: - Claim processing - Provider demographic information - Insurance billing practices Soft Skills: - Ability to prioritize and manage multiple tasks - Proven ability to work in a team setting - Excellent oral and written communication skills and presentation skills - Critical thinking, problem solving and analytical skills - All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

Title: Clinical Quality Consultant - Oncogenetic Program - Remote Primary location: Dallas, TX Additional locations: Minneapolis, Minnesota | New York, New York | Los Angeles, California | Miami, Florida | Atlanta, Georgia | Houston, Texas | San Antonio, Texas | Seattle, Washington Requisition number: 2353640 Job category: Medical & Clinical Operations Overtime status: Exempt Travel: No Job Description: Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Quality Consultant for the Oncogenetic Program provides guidance and support for utilization management related to advanced molecular and genetic testing in oncology. This role ensures evidence-based decision-making, compliance with regulatory standards, and optimal patient outcomes through expert interpretation of genomic data and collaboration with multidisciplinary teams. The position requires experience in molecular pathology and oncogenetics, combined with demonstrated collaboration skills and the ability to thrive in a fast-paced, technology-driven environment. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Work to improve quality and promote evidence-based medicine - Ensure the right service is provided at the right time for each member - Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - PhD degree in molecular pathology, genetics, or similar - 5+ years of clinical experience in oncology or genetic medicine - Experience with genomic data interpretation software (e.g., NextGen sequencing analysis tools) - Knowledge of regulatory and compliance standards (CMS, NCCN, ASCO guidelines) for genetic testing and oncology care - Familiarity with molecular diagnostic coding systems and claims platforms - Proficiency in interpreting next-generation sequencing (NGS) and other advanced molecular diagnostic technologies - Proven ability to work effectively in a fast-paced, technology-driven environment - Proven ability to review work performed by others and provide recommendations Preferred Qualifications: - Hands-on utilization and/or quality management experience - Experience in using electronic clinical systems - Proven to serve as a key resource on complex molecular diagnostic cases - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Title: Health Coach Location: New York United States Job Description: Company Overview: About Public Health Solutions Health disparities among New Yorkers are large, persistent, and increasing. Public Health Solutions (PHS) exists to change that trajectory and support underserved New Yorkers and their families to achieve optimal health and build pathways to reach their potential. As the largest public health nonprofit serving New York City, we improve health outcomes and help communities thrive by providing direct services to underserved families, supporting community-based organizations through our long-standing public-private partnerships, and bridging the gap between healthcare and community services. To learn more about our work, please visit healthsolutions.org. Program Description: In partnership with Stanford University, Public Health Solutions has been awarded a 5-year research grant from the Patient Centered Outcomes Research Institute (PCORI) focused on advancing maternal health equity. The goal of the CHIME study (Comparing Health Interventions for Maternal Equity) is to compare three different approaches to overcoming barriers to maternal healthy weight and chronic disease prevention. The community-based arm of the study will provide culturally relevant nutrition and physical activity and Health Coach support for pregnant and postpartum patients to improve maternal healthy weight in pregnancy and postpartum to prevent adverse maternal infant health outcomes. Summary of Position: PHS is seeking a health coach to fulfill the following duties: - Provide health education and home visiting services to pregnant participants throughout pregnancy and through 12- months postpartum. - Facilitate curriculum-based group health education workshops and support enrolled participants in the CHIME study with maternal & child health resources in their community. - Responsible for working with participants on their nutrition, physical activity, and lifestyle goal setting, as well as a detailed social needs screening, assessment, and referral. - Meet with participants on a weekly basis (at their home, in the office, or in the community) and keep detailed notes on their progress and activities, providing in-person support, text-message resources, and referrals to community services. - Manage caseload of up to 30 participants at a time and meet all stated program goals. - Follow guidelines from the Health Coach Manual on proper and in-depth case note documentation and tracking participant enrollment and progress in the study. - Regularly collaborates with program manager, study primary investigators (PIs), research coordinators, other team members, and nutrition/physical activity consultants to troubleshoot adverse events that may arise or discuss participants. This is a grant-funded position ending 6/30/30. Salary: $54,500.00 -$54,500.00 Qualifications and Requirements: - Preferred: Bachelor's degree in community/public health, social work, health coach, or related. - Experience: 1-2 years - Live in the tristate area (NY, NJ, CT), be willing to take public transportation or drive to home visits. - Bilingual preferred, but not required, in Spanish or Haitian Creole. - Demonstrated commitment to, and interest in learning more about maternal child health, systems approach to health equity, reproductive justice, racial justice, and community services in NYC. - Has experience with facilitating workshops or presenting health information in an engaging way to diverse audiences. - Prior experience with community-based outreach, conducting screening and wraparound services, and community engagement strategies preferred. - Ability to communicate effectively both orally and in writing with an attention to detail and professionalism in all communications. - Demonstrated strong interpersonal skills and respectful interactions with community members looking for services. - Must be comfortable conducting home visits in diverse neighborhoods and settings throughout NYC (i.e., homes, public housing, shelters, community centers, etc.). - Demonstrated experience performing administrative duties with speed and accuracy without immediate and constant supervision. - Must be highly organized and detail-oriented. - Collaborative spirit, seeking out how to be most helpful to the team. - Must interact well with staff and clients alike and have an outgoing personality. Benefits: - Hybrid Work Schedule. (i.e., 4 days in-person/community and 1 day work from home). This is subject to change based on program needs. - Generous Paid Time Off and Holidays. - An attractive and comprehensive benefits package including Medical, Dental and Vision. - Flexible Spending Accounts and Commuter Benefits. - Company Paid Life Insurance and Disability Coverage. - 403 (b) + employer matching and discretionary company contributions. - College Savings Plan. - Ongoing training and continuous opportunities for professional growth and development. At PHS, we place immense value on diversity within our teams, understanding that varied backgrounds and experiences significantly enhance our community and propel us toward our goals. If you find you don't have experience in all the areas listed above, we still encourage you to apply and share your background and experiences in your application. We are eager to discover how your unique perspective can bring positive transformations to our team and help advance our mission of creating healthier, more equitable communities. We look forward to learning more about you. PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans. 9:00am to 5:00pm 35 Hours per week