Develop and execute Internal Audit department operations, methodology, technologies and tools, and continuous improvement efforts in alignment with direction provided by the OSCaR Leader, IAAS leadership, IIA audit standards, the Internal / External Audit Policy and the Charter of the UHG Board of Directors Audit Committee Ensure policies, procedures, and other core depar

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

If you reside within Western, KY you will have the flexibility to telecommute as you take on some tough challenges. Primary Responsibilities Functioning independently, travel across assigned territory to meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members. Will be out in the field 80% of time in d

As part of a multi disciplinary care coordination team Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prio

Extensive work experience within own function. Work is frequently completed without established procedures. Works independently. May act as a resource for others. May coordinate others' activities. Extensive work experience within own function. Applies knowledge/skills to a range of moderately complex activities. Demonstrates great depth of knowledge/skills in own functio

The preparation of quarterly and annual income tax provisions The timely and accurate preparation of federal and state income tax returns and quarterly estimates Assist with the IRS examination Assisting Tax leadership with M & A and other related projects Providing research support for the analysis of proposed and existing tax laws, regulations, and rulings Prepare and r

Positively represent the Company to both internal and external customers; always maintain a professional and courteous manner Uphold the Optum core values in the conduct of work Adhere to Company privacy guidelines; ensure compliance with local, state, and federal regulations Assess patients prior to initiation of home care service for appropriateness of services prescrib

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

Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements Engage with requesting providers as needed in peer to peer discussions Be knowledgeable in

Seeking process improvement through efficiency or technology advancements in all areas of work Assisting with UHG's quarterly international tax provision and effective tax rate projections, including coordination with non US business lines Preparing US international tax compliance and reporting forms (including Forms 5471, 8858, 8865, 1118, etc.) Preparing responses to in

Conduct coverage review based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer to peer telephone calls Use clinical knowledge in the application and interpretation of medical policy and benefit document language in the process of clinical co

Partners with business leaders to scope, create and execute business analytics using the appropriate data aggregation and visualization tools Creates backlog and prioritization methodology for analytics requests Evaluates existing tools and processes to create a long term strategy for sustainable analytics in a scaled business, offering ease and efficiency of data visuali

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

Develop, lead and execute category management strategies, conduct sourcing / RFX events, manage suppliers and conduct financial analysis Primary responsibilities surround Pharmaceutical Draft, Review, and lead negotiations of third party supplier contracts, including Master Services Agreements (MSAs), Statements of Work (SOWs), Non Disclosure Agreements (NDAs) and amendme

The MarTech and Digital Strategies leader is responsible for the following Oversee E&I's implementation of the new Adobe suite of products (AJO, CDP, Assets) Represent E&I's priorities to Evolution program technical leadership. Strategic planning and roadmap of the E&I MarTech stack; a collection of 15+ platforms representing a $4MM+ annual marketing operations investment