Assess, plan and implement care management interventions that are individualized for each member and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for both healthcare and community based services; including but not limited to financial, psychosocial, community and state supportive services Develop and implement care

Build and maintain solid relationships with key brokers and others as necessary within the assigned territory Develops action plans and strategies to optimize Medicare sales Partner with the Community Developer (CD) and Sales Director (SD) to identify and develop relationships with individuals and organizations that influence the buying behavior of our target consumer (e.

Supervise the daily operations of NMC staff Be available to assist staff with risk calls or calls requiring additional consultation Coach and train current staff, deliver information to NMC team regarding new and changed procedures, policies, etc. Monitor and manage individual and team performance; offer constructive and positive feedback to team members and coaching for

Field inbound calls in a queue from members and providers for purpose of assessment and triage Focus on initial inpatient admission for psychiatric and chemical dependency patients Make patient assessments and determining appropriate levels of care Participate in member crisis calls Determine if additional clinical treatment sessions are needed Manage inpatient mental hea

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Provide skilled nursing care for expectant mothers in the home care environment Travel to provide in home patient care and continuous education to patients and family members Continually assess the mothers' condition to ensure they are safe in the home environment Modify the plan of care, as appropriate, based upon reassessment, change in prescriber orders, the patient's

Sales representative for the UHC Key Accounts responsible for broker and direct sales to customers in the 100 5000 employee range. The principle focus is the sale of new fully insured and self funded business with indirect responsibility for the retention of existing accounts New Business Sales Identifies potential healthcare business customers Accountable for prospect fr

Provide Key Accounts new business sales support for the Account Executives handling cases in the 100 5,000 segment for Medical and Specialty (ancillary) products Will also provide support for the Strategic Account Executives managing existing Key Accounts cases in offering new coverages (i.e., renewal upselling) Coordinate and execute the new business presale process to a

Relationship Building Uses our CRM tool to create a proactive engagement plan and monitor engagements for assigned groups Develop and maintain solid customer and broker relationships, in person and telephonically Partner with the local team and other Field Based Staff Develop and maintain key internal relationships Understand customer needs, where to prioritize efforts, a

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

Telecommute Healthcare Advocate

Telecommute CDI Specialist (St. Louis, MO)