Collaborates with the University Bursar, Registrar, IT Services and Web Services departments to ensure smooth processes throughout the insurance plan year. Coordinates the administrative aspects of a competitive bid process for USHIP and the optional insurance plans. Maintains the University Student Health Insurance Administration Tool, which tracks students' annual enrol

Manage and monitor client assignments Training of account management staff, new hire and ongoing Maintain an acceptable level of persistency in teams book of business Recruit, hire and monitor account management staff Personnel development and management Set account management strategy to achieve goals Direct and manage service plans Build and maintain key client and prod

Participates in the application technical design process with the Application Architects on development projects Ensures and contributes to testability of requirements and/or user stories Clarifies ambiguities in requirements, user stories, design and other artifacts produced as part of the product lifecycle Develops, implements, and maintains quality and test procedures,

Research issues and develop customers specific solutions Provide in person Member services to both M&R and DSNP members with their languages at retail store, services including but not limited to Benefits Policies, Procedures, and protocols (pre auth, enrollments, renew rewards, etc.) Claim / billing issues (follow up calls with resolution to identified issues in timely m

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Utilize both company and community based resources to establish a safe and effective case management plan for members Collaborate with patient, family, and healthcare providers Identify and initiate referrals for social s

Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

Manage and execute the proposal production for assigned RFPs in accordance with the established project process Analyze RFP documents to identify and document specific proposal production requirements and participate in meetings to ensure appropriate production strategies are in place and fully compliant with all production requirements for a given opportunity Create prop

Serve as a resource or Subject Matter Expert for team members or internal customers. Handle escalated calls, resolve complex customer issues. Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner. Attend local health events as needed. Assist customers in navigating healthplanofneva

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Apply knowledges / skills to activities that often vary from day to day Demonstrate a moderate level of knowledge and skills in own function Make outbound calls to members who are eligible to participate in one of our Health Management coaching programs Receive inbound calls to enroll members & / or provide customer service Require little assistance with standard and non

Organize and manage incoming claims Work through a queue with other team members to identify claim needs Identify billing discrepancies Determine member insurance coverage and eligibility status Ensure compliance with federal and state laws and regulations Sort and organize appeals to identify eligibility needs Communicate with legal teams on appeal status Make offers to

Engage members either face to face or over the phone to have a discussion about their health Review available member service records and relevant documentation (e.g., utilization history, functional level, stratification information, current plan of care) Conduct comprehensive member assessment that includes bio psychosocial, functional, and behavioral health needs Utiliz

Forge relationships with key customers and consultants, and act as main contact for UnitedHealthcare and as "CEO" of their account Renew the customer year over year in the 100 3000 lives segment Clearly demonstrate the value propositions for specialty and ancillary business to improve customer growth and retention Develop and monitor client financial performance, includin

Analyze, review, forecast, and trend complex data Present analysis and interpretation for operational and business review and planning Support short and long term data warehousing activities through analysis Develop recommended business solutions through research and analysis of data and business process and implement when appropriate Skills with influencing others to get

As requested, provide support to consumer or family members in making needed appointments Work with the Clinical Program Managers and the Clinical team to implement intensive, enhanced care coordination when requested, which may include peer support as well as other community based services designed to stabilize the consumer's condition, including working with the consume