Following physicians' orders, produces CT exams following departmental protocol for the use in diagnosing medical problems/Verifies valid provider order for accuracy/Follows standard of work Provides excellent customer service for internal and external members/Greets, correctly identifies patient, prepares patient for examination, and explains specific procedures to be pe

Analyzes detail delegate encounter reports and identify issues timely to appropriate business partners for remediation of issues and escalate as needed. Performs ongoing monitoring to ensure encounters are received timely, accurately, and completely. Uses technical skills to lead individual issue remediation efforts with the delegate. Leads deep dive focused calls with de

Provide transactional legal support for the OptumInsight Growth team's sales functions by being a key drafter and negotiator of complex vendor and commercial contracts Draft, review, revise and negotiate high volumes of complex agreements, from both commercial and vendor perspectives, including (i) master SaaS agreements, (ii) master license and services agreements, (iii)

Serve as the operational manager for administrative services for National Accounts customers Service products that contribute to the continued growth, profitability and retention of business Manage the overall delivery of benefits and services for assigned clients Responsible for and ownership of all customer service results Our business continues to evolve and change and

Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers Handle escalated calls, resolving more complex customer issues in a one and done manner 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 explan

As a part of the Optum Care network, ProHealth Physicians is seeking a Primary Care Nurse Practitioner to join our growing Express Care Team. At Optum, we are transforming healthcare nationally while providing Physician led care locally. Work with the largest care delivery organization in the world and start doing your life's best work.(sm) Position Highlights Per Diem Ad

Work over the phone with hospitals, clinics, facilities and the clinical team to manage requests for services from providers Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review Handle resolution / inquiries from mem

Assist in the development and preparation of regulatory reports Perform quantitative analysis on healthcare membership and claims data Design, support, and enhance comprehensive data cleaning, standardization, and validation programs Maintain and improve robust quality assurance process to ensure accuracy Design and support ad hoc analytics where needed Collaborate and co

Develop and deploy predictive data models on large data sets Use statistical, data science and machine learning skills to perform analytics using healthcare data Perform quantitative analysis on Actuarial, financial, utilization and costs data Assist in developing consulting offerings, products and services solutions that align with key market needs and or client initiati

Manages patient placement and bed board functions Contacts insurance carrier(s) to obtain all information necessary for the successful billing of 3rd party payers (coordination of benefits, benefit coverage / limits, co pay / deductible amounts, authorization, pre certification and referral requirements etc. Re verifies insurance of recurring patients Performs financial a

Manages patient placement and bed board functions Contacts insurance carrier(s) to obtain all information necessary for the successful billing of 3rd party payers (coordination of benefits, benefit coverage / limits, co pay / deductible amounts, authorization, pre certification and referral requirements etc. Re verifies insurance of recurring patients Performs financial a

Analyze and interpret data to identify trends, patterns and opportunities for the operations team Using Business intelligence tools to conduct analysis, perform normalization of operations and assuring data quality Communicate analysis and interpretation to appropriate audiences Understand data requirements and develop tools and models such as dashboards, data visualizati

Designs, writes, creates, and maintains curriculum and adoption materials, including multimedia deliverables, to lead in person and virtual instructor led training, self paced online learning, and other system adoption initiatives for a variety of audiences as assigned Incorporates instructional design best practices and adult learning theories to address a target audienc

Enter prescriptions and verifying appropriate information Contacting patients, pharmacists and doctor's offices to resolve claims issues Process prescriptions (from intake to order completion) Resolve customer issues; ensuring accurate information is provided Consistently meet established productivity, schedule adherence, and quality standards while maintaining a good att

Devoted to service Energized by impact The Pre Service Coordinator plays an integral role in optimizing the patient's recovery journey. The Pre Service Coordinator is responsible for reviewing pre authorization requests for skilled nursing and rehabilitative services and determining if requests meet medical necessity for the requested level of care. The position coordinat