Manage the evaluation of payer proposals related to Fee For Service (FFS), capitation arrangements and value based contracts Partner with the payer contracting team to manage the modeling and negotiation process, evaluate proposals, and provide guidance to senior leadership on the financial impact and viability of the contract Work closely with the Finance and Actuarial t

Supervises clinical operations of a given patient care area Assists Site Administrator in ensuring compliance with licensing, certification, and competencies Evaluates nursing competencies and decisions according to current nursing practices Functions as a resource and serves as a liaison between administration, clinicians, staff, and other departments Participates in all

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Position in this function is responsible for all activities associated with Utilization Management (UM) programs. Ensures all UM activities a

Family Medicine Physician Los Angeles, CA 2225680 NOTICE OF FILING OF APPLICATION FOR PERMANENT EMPLOYMENT CERTIFICATION This Notice is being provided as a result of the filing of an application for permanent alien labor certification for the position shown below. Any person may provide documentary evidence bearing on the application to the Certifying Officer, U.S. Depart

Maintain successful relations with customers and potential customers by interacting professionally and pro actively Promote strategic growth for the company by identifying leads and closing transactions; may include concentration on growing mental health and substance use treatment facility footprint, residential/group home consumer base, ACT/FACT teams, and other opportu

Consistently exhibit behavior and communication skills demonstrating Optum's commitment to superior customer service, including quality, care, and concern with every internal and external customer Closely monitor patient safety at all times, i.e., will not leave the patient on an exam table unattended and participate in the Optum fall prevention program. Comply with Optum

Direct billing and collections initiatives within their assigned Client Develop and implement strategic plans for meeting metrics Fosters an environment that promotes teamwork and positive communications within the service area and department Works collaboratively and strategically with the Revenue Cycle team to develop and operationalize processes and procedures, with co

Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer Maintains an on time patient appointment schedule in accordance with established department standard for productivity. Alters schedule to meet department or patient

Consistently exhibit behavior and communication skills demonstrating Optum's commitment to superior customer service, including quality, care, and concern with every internal and external customer Closely monitor patient safety at all times, i.e., will not leave the patient on an exam table unattended and participate in the Optum fall prevention program Comply with Optum'

Applies knowledge/skills to activities that often vary from day to day. Assist member and answer any questions they have Answering an average of 50 calls per shift Demonstrates a moderate level of knowledge and skills in own function. Requires little assistance with standard and non standard requests. Solves routine problems on own. Works with supervisor to solve more com

Conduct solution focused consultations; helping clients define goals, plan action and gain insight Assess and refer to appropriate programs and services including but not limited to Work life, behavioral health, substance abuse / chemical dependency and community based resources Assist with referrals for members needing ongoing/additional counseling services Provide limit

Come join our Primary Care team at Optum where we believe in providing quality of life to our clinicians. We offer excellent work life balance with no pager, no call, no weekends. We are looking for a Physician Assistant in our Van Nuys, CA office. This is an excellent position to further your professional growth. Position Details Clinic Location 14600 Sherman Way, Van Nu

Come join our Primary Care team at Optum where we believe in providing quality of life to our clinicians. We offer excellent work life balance with no pager, no call, no weekends. We are looking for a Nurse Practitioner in our Van Nuys, CA office. This is an excellent position to further your professional growth. Position Details Clinic Location 14600 Sherman Way, Van Nuy

Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist providers and members with basic inquiries about claims, authorizations, benefits, and other issues Fostering and maintaining proactive, positive relations throughout the provider network by communicating with provider offices through face to face visits, emails, telephone

Delivers high quality patient care through face to face, telephone, and electronic contact for examination, treatment, monitoring, and preparation for diagnostic tests or procedures Collects and documents patient information, including vital signs, chief complaints, review of medications, allergies, health risk screen information, the status of extended care benefits, and