Investigations Refine investigation protocols, documentation standards, and policy interpretation guidelines in partnership with Employment Law and ER Case Management leadership Conduct thorough, timely, objective, efficient and equitable investigations into employee complaints and allegations of misconduct, in line with agreed upon investigation framework and applicable

Develop, lead and execute category management, sourcing/RFx, vendor management and financial analysis efforts across the Enterprise in human capital, legal services and other indirect spend categories as assigned Review, develop, redline, and negotiate complex third party vendor contracts, including Master Services Agreements (MSAs), Statements of Work (SOWs), Non Disclos

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 diversity and inclusion, talented peers, c

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 business counsel for the Optum Technology organization Provide legal support for transactional matters, such as software licenses, cloud computing arrangements, collaboration and joint development agreements, supply agreements, equipment purchase and lease agreements, mobile app development agreements, offshore sourcing arrangements, and IT services agreements Ne

Develops functional, market level, financial plans, and/or organizational priorities Lead large, complex projects to achieve key business objectives Provides leadership to and is accountable for the performance of senior level professional staff, developing future leaders for the organization Impact of work is most often at market level Direct work that impacts commercial

Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) Analyze payment appendices to provide options for various contracting approaches and methodologies Communicate results of financial impact and analysis to appropriate st

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,

Deliver technical immigration case consultations, provide guidance and education on GMIT best practices and policies to internal stakeholders Provide consultative guidance including assessing visa eligibility. Partner with immigration counsel to provide immediate and long term strategic case recommendations Partner with managers, talent acquisition, people business partne

Advise UnitedHealthcare's Medicare Part D business Counsel on Part D product, clinical (Pharmaceutical & Therapeutic Committee, formulary development), marketing, and regulatory requirements Provide strategic counsel to the business on the Pharmacy Benefit Management (PBM) Agreements, benefit implementation and management, and compliance oversight and monitoring Provide c

Perform telephonic member outreach and document telephonic interaction outcomes using appropriate note templates Follow standard operating procedures and utilize required scripting Deliver member outreach using a motivational interviewing style of communication Perform medication and disease state clinical discussions to improve health outcomes Use active and reflective l

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Confirm contract compliance requirements to meet the needs of Turquoise Care contract network standards Possess knowledge of Managed Care Organization (MCO) contracting/credentialing process Experience working with providers/facilities in order to conduct advocacy initiatives with targeted providers to solicit participation Work with cross functional teams within UnitedHe

Apply clinical knowledge to Case Managers behavioral health reviews to enrollee's identified as needing or receiving behavioral health services Conduct behavioral health consults with Case Managers, daily and maintain a quarterly schedule for identified members needing or receiving behavioral health services Serve as member advocate by addressing stigma, following Guiding