31 to 45 of 54
Assist in end to end provider claims and help enhance call quality Coach, provide feedback and guide others Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Help implement traini
Posted 12 days ago
Manage contracting efforts for network expansion projects Predict emerging customer needs and develop innovative solutions to meet them Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate contracts in compliance with company templates, reimbursement structure s
Posted 15 days ago
Evaluate, manage, and negotiate large national home infusion & specialty pharmacy contracts, reimbursement structure standards and other key process controls Forecast contract impacts to UHC lines of business, departments, health plans and Optum affiliate companies In coordination with UHC healthcare economics and national ancillary colleagues, manage departmental unit co
Posted 15 days ago
Fraud Lead generation by analyzing and interpreting data to identify trends, patterns and opportunities for the business and clients. Perform data manipulation activities for the fraud investigations team including data extracts, summaries, random sampling, and special projects Prepare Healthcare claims data for investigative business needs and work with investigations te
Posted 17 days ago
Fraud Lead generation by analyzing and interpreting data to identify trends, patterns and opportunities for the business and clients Perform data manipulation activities for the fraud investigations team including data extracts, summaries, random sampling, and special projects Prepare Healthcare claims data for investigative business needs and work with investigations tea
Posted 17 days ago
Analyze and investigate customer issues with structured and unstructured data Work collaboratively with People Analytics and People Analytics customers in the development and production of standard and customized rapid response reporting and data visualization to drive actionable decision making Assess and interpret customer requests for feasibility, priority, and complex
Posted 17 days ago
Collaborate with Product Analytics leaders and Product stakeholders to define and prioritize analytic roadmap Manage and develop a team of researchers and data analysts by leading projects from conceptualization to completion Guide your team to develop and present analytic value stories which demonstrate the impact of Optum Health's Health Equity products Recommend approp
Posted 17 days ago
Aon
- Bloomington, MN / Chicago, IL
Aon is looking for a Pharmacy Sr. Consultant As part of an industry leading team, you will help empower results for our clients by delivering innovative and effective solutions supporting Health Solutions from our Bloomington, MN office but with flexibility to other locations such as (Chicago, IL and Atlanta, GA) Your impact as a Pharmacy Sr. Consultant Job Responsibilitie
Posted 18 days ago
Manage unit cost budgets, target setting, performance reporting and associated financial models Establishing and maintaining solid business relationships with Physician and Hospital providers Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls Forecast and plan ongoing contract renewal str
Posted 18 days ago
Manages the product to maximize value to the end buyer and end user Routinely utilize project management, enhancement and development processes, to manage new and existing products, projects and platforms and to evaluate product modifications Will be closely aligned with and support Operations and Product strategies to maximize value to our customers Communicate and assis
Posted 19 days ago
Aon is looking for a Health Solutions, Audit Consultant/Sr. Audit Consultant for our Pharmacy Audit Practice As part of an industry leading team, you will help empower results for our clients by delivering innovative and effective solutions as part of our National Pharmacy Practice within Aon's Health & Benefits Consulting Practice. This role will ideally be based out of o
Posted 20 days ago
Develop and maintain facility and professional payment appendix language to support government program reimbursement strategies Understand government programs reimbursement strategies for various provider types Research and collaborate with appropriate business owners to support market needs Coordinate with business partners such as system configuration and affordability
Posted 20 days ago
Develops robust reporting processes and procedures to ensure timely and accurate reporting for management and staff on a wide variety of business metrics Contributes to analysis, problem definition, requirements gathering, solution development Troubleshoots data integrity issues, analyzes data for completeness to meet business goals Transforms data into meaningful and eas
Posted 21 days ago
Analyze plan characteristics, assess past experience as to frequency and severity of loss, assess current ongoing risks, utilizes established underwriting criteria, policies and methodologies to establish a profitable quote/pricing Anticipate customer needs and proactively develops solutions to meet them Serve as a key resource on complex and/or critical issues Solve prob
Posted 21 days ago
Generally work is self directed and not prescribed Works with less structured, more complex issues Serves as a resource to others Assesses and interprets customer needs and requirements Identifies solutions to non standard requests and problems Solves moderately complex problems and/or conducts moderately complex analyses Works with minimal guidance; seeks guidance on onl
Posted 23 days ago
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