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The Escalation Response Specialist III is responsible for managing and resolving escalated complaints from members and providers. This role involves documenting issues, identifying trends, coordinating with various departments to facilitate issue resolution, and providing updates to stakeholders to enhance the customer experience.
The Regional Agency Manager is responsible for achieving annual sales goals related to the Medicare book of business, engaging with community organizations and brokers, responding to escalated issues, conducting training, and developing best practices based on market conditions. The position requires significant travel and building strong relationships internally and externally.
The Contract Negotiator coordinates and negotiates service agreements with providers, ensuring compliance with corporate and health plan guidelines. Responsibilities include recruiting providers, leading negotiations, monitoring performance standards, and facilitating contract compliance. The role may require travel up to 25%.
The Data Analyst II will manage analytical data needs, handle complex data requests, and perform predictive modeling. Responsibilities include data collection, validation, and reporting, as well as trend analysis in health care management.
The Manager of Application Development Engineering leads a team responsible for designing, developing, and implementing enterprise software solutions. The role involves coaching junior developers, ensuring compliance with coding standards, collaborating with various stakeholders, managing third-party vendors, and overseeing the hiring and training of team members.
The IT Technical Support Specialist II provides remote and on-site technical support to end users and IT infrastructure, troubleshooting hardware and software issues. Responsibilities include managing computers, networks, and user training while complying with procedures and standards.
Supports community connection activities and provides necessary care resources in a cost-effective manner. Coordinates outreach resources, assists in member inquiries, and documents community resources. Conducts health assessments and outreach to locate hard-to-reach individuals. Requires 1-2 years of related experience and a High School diploma or GED.
The Manager, Optum Configuration will lead a team to manage the analysis and configuration of claims information systems. Responsibilities include overseeing claims pricing, monitoring production and accuracy of configurations, developing tools for change requests, and implementing project management tasks while evaluating programming techniques.
The Supervisor of Operations is responsible for leading and managing a team, ensuring timely processing, developing operational policies, monitoring production effectiveness, handling customer inquiries, and coordinating with other departments to enhance efficiency.
Analyze and resolve claims and authorization appeals from providers and pursue resolutions for grievances from members. Responsibilities include gathering and analyzing complaints, preparing response letters, and managing large volumes of documents related to grievances and appeals.
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