Maintain detailed knowledge of State and Federal insurance programs and effectively utilize such programs to insure all eligible are enrolled in appropriate MassHealth programs Maintain detailed knowledge of MassHealth and attend all required MassHealth training forum meetings Assist in eligibility determination and completion of MassHealth applications Monitor, analyze a

Develop Others into a successful team aimed at increasing growth and market permeation by Continually building and nurturing agents through educational support on product information, selling skills, systems, and processes at United Healthcare Actively engage in the management and coaching of agent performance by implementing successful start strategy and guiding agents t

Maintain detailed knowledge of State and Federal insurance programs and effectively utilize such programs to insure all eligible are enrolled in appropriate MassHealth programs Maintain detailed knowledge of MassHealth and attend all required MassHealth training forum meetings Assist in eligibility determination and completion of MassHealth applications Monitor, analyze 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

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease 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 Com

Make outbound dialer and manual calls to members in regard to cancer support services Take inbound calls from members regarding cancer support services Determine if the consumers are eligible for a health program Schedule initial appointments with a nurse Must have accurate documentation Must meet monthly metrics Other duties as assigned You'll be rewarded and recognized

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

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

Review and assess individual member clinical cases for high priority medication related opportunities and recommendations Provide written, consultative medication recommendations for interdisciplinary care management team members Directly contact medical providers over the telephone as needed to discuss pharmacy related consultative recommendations and provide benefit rel

The KA Field Account Manager is accountable for the field based service of small to mid size, standard/non standard customers under 1,000 members. In this position, the KA Field Account Manager is responsible for the following Acts as a strategic partner and consultative resource to the customer, responsible for the customer's total service experience Meets with customers

Own the service experience of customers at the field level by working with the Regional Service Team and other matrix partners as required to ensure issues are resolved promptly and accurately meeting the customer's expectations Develop and maintain strong relationship with internal partners in Service Team to manage customer service experience Fully accountable for suppo

Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review This is high volume, customer service environment. You'll need to be efficient, productive, and thorough dealing with our member's claims. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it take

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

Assist Managers and Supervisors with escalated issues Assist in development of training materials; acts as Subject Matter Expert Fields questions and serves as a resource for Clinicians and non clinicians Reviews and updates job aids to maximize quality and productivity Trend, analyze and improve processes and suggests improvements Participate in quality improvement initi

Support case and disease management teams to achieve optimal clinical outcomes for high risk populations Proficient in evidence based clinical guidelines and lead grand round clinical education sessions with nursing teams Primary functions include RN case manager support and consultation about high risk members and assisting in account management team presentations Be inv