• Assegurar a condução eficiente dos projetos em saúde corporativa dos clientes HBit; • Definir e monitorar rigorosamente o desempenho e status de cada projeto; • Analisar as diretrizes e objetivos do projeto; • Desenvolver e fomentar indicadores, dashboards e relatórios de progresso; • Assegurar a comunicação e integração eficiente entre os times operacionais e de suporte; • Identificar gargalos dos projetos para otimizar o staff; • Remover impedimentos que dificultam o progresso do projeto; • Promover melhoria contínua dos projetos.

Role Description The Itemized Bill Review (IBR) Clinical Appeals Reviewer will analyze and respond to client and/or hospital claim review appeal inquiries. Handles medical record review, analyzes data, and completes the response resolution for clients and the business unit. Must utilize expertise in auditing to review and provide response to appeals. We are seeking self-motivated, solution-oriented and skilled problem solvers who provide clinical reviews with written documentation under tight deadlines. This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Analyze scope and resolution of IBR Appeals - Respond to Level one, two or higher appeals - Perform complex conceptual analyses - Identify risk factors, comorbidities, and adverse events to determine if overpayment or claim adjustment is needed - Review governmental regulations and payer protocols and/or medical policy to recommend appropriate actions - Research and prepare written appeals - Exercise clinical and/or coding judgment and experience - Collaborate with existing analysts, quality and leadership team to seek to understand and review medical records pertaining to impacted claims - Navigate through web-based portals and independently utilize other online tools and resources including but not limited to Word, Adobe, Excel - Serve as a key resource on complex and/or critical issues and help develop innovative solutions - Define and document/communicate business requirements Qualifications - Undergraduate nursing degree - Unrestricted RN (registered nurse) license - 2+ years of appeals experience (coding or auditing) - Experience with CPT-4 coding, NCCI edit resolution and appropriate modifier use - Advanced experience with regulations, compliance and composing professional appeal responses - Advanced experience with ICD10 CM coding and ICD 10 PCS coding - Willing or ability to work our normal business hours of 8:00am - 5:00pm - Proven ability to keep all company sensitive documents secure (if applicable) - Have a dedicated work area established that is separated from other living areas and provides information privacy - Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Preferred Qualifications - Clinical claim review experience - Managed care experience - Investigation and/or auditing experience - Advanced experience using Microsoft Excel with the ability to create/edit spreadsheets, use sort/filter function, and perform data entry - Knowledge of health insurance business, industry terminology, and regulatory guidelines Requirements - *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Benefits - 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). - The hourly pay for this role will range from $35 - $63 per hour 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.

• Implementing, maintaining, and optimizing Workday Human Capital Management (HCM) functionalities. • Working closely with HRIS Product Owners and responsible for Workday configuration, analytics, reports, integrations, and security. • Collaborating with HRIS organization, External Application Managed Services, IT, HR, Payroll, and Finance to understand business processes and compliance requirements, evaluate system impacts, and deliver scalable Workday solutions that align with business objectives and support long-term system sustainability. • Resolving enhancement requests from monthly release and enhancement cycles across Workday HCM modules, partnering with HRIS Product Owners and business stakeholders to design, document, test, and deploy scalable solutions. • Participating actively in Workday HCM enhancement initiatives, system upgrades, and support projects, serving as a functional and technical subject matter expert. • Configuring and maintaining Workday functionality including business processes, reports, integrations, calculated fields, and analytics while ensuring solutions are designed for long-term scalability and maintainability. • Reviewing business requirements with stakeholders, recommending appropriate system solutions, and configuring and deploying enhancements aligned with business objectives and Workday best practices. • Maintaining detailed system documentation in accordance with SOX and SDLC requirements established by Alignment Healthcare. • Managing and resolving HRIS support cases within established service level agreements (SLAs), ensuring timely resolution and clear communication with stakeholders. • Developing and maintaining user guides, job aids, and process documentation with a focus on improving the employee and manager user experience. • Supporting internal and external audits by providing system documentation, data validation, and evidence of controls and compliance processes.

Role Description This job plays a critical role in the execution and analysis of programmatic advertising campaigns. It requires a blend of technical expertise, strategic thinking, and effective communication. The position supports ongoing optimization efforts and contributes to the team's understanding of campaign performance. This position is not eligible for visa sponsorship. Applicants must be authorized to work for Comcast in the United States without a current or potential future need for sponsorship. This is a virtual opportunity with working hours for Pacific, Mountain or Central time zone. Responsibilities - Developing optimization tactics and strategies for programmatic campaigns to enhance customer experience - Providing troubleshooting and quality assurance support for programmatic campaign performance issues - Recommending performance improvements based on analysis of campaign data and market insights - Analyzing bid data to identify and solve technical bidding challenges - Reviewing programmatic bid data and historical marketplace activity to boost private marketplace outcomes - Collaborating with cross-functional teams to integrate programmatic efforts with wider advertising goals - Assisting in the creation of reports on campaign performance, delivering insights to internal teams - Continuing to learn and apply new skills in programmatic technology and data analysis - Executing programmatic campaigns, monitoring their performance, and adjusting strategies as needed - Communicating analytical findings and strategic recommendations to stakeholders effectively - Consistent exercise of independent judgment and discretion in matters of significance - Regular, consistent and punctual attendance. Must be able to work nights and weekends, variable schedule(s) as necessary - Other duties and responsibilities as assigned Employees at all levels are expected to: - Understand our Operating Principles; make them the guidelines for how you do your job - Own the customer experience think and act in ways that put our customers first, give them seamless digital options at every touchpoint, and make them promoters of our products and services - Know your stuff be enthusiastic learners, users and advocates of our game-changing technology, products and services, especially our digital tools and experiences - Win as a team make big things happen by working together and being open to new ideas - Be an active part of the Net Promoter System a way of working that brings more employee and customer feedback into the company by joining huddles, making call backs and helping us elevate opportunities to do better for our customers - Drive results and growth - Support a culture of inclusion in how you work and lead - Do what's right for each other, our customers, investors and our communities Qualifications - Communication - Programmatic Campaign Management - Programmatic Media Buying - Programmatic Trading - Teamwork - Troubleshooting Requirements - Bachelor's Degree (Required) - 2-5 Years of Relevant Work Experience Compensation - Primary Location Pay Range in California: $68,914.44 - $91,885.92 USD - Pay Range in Colorado: $59,925.60 - $103,371.66 - Base pay is one part of the Total Rewards that Comcast provides to compensate and recognize employees for their work - Most sales positions are eligible for a Commission under the terms of an applicable plan, while most non-sales positions are eligible for a Bonus - Comcast provides best-in-class Benefits to eligible employees Disclaimer This information has been designed to indicate the general nature and level of work performed by employees in this role. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications.