Operations Manager, Medicaid Account Management Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes
Essential Duties and Responsibilities: - Supervise a team of employees through cultivation of a high performance team - Ensure adequate staff coverage for assigned program area - Serve as subject matter expert for identified area of program knowledge
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases
Essential Duties and Responsibilities: - Perform hands-on data analysis and modeling with huge data sets. - Apply data mining, NLP, and machine learning (both supervised and unsupervised) to improve relevance and personalization algorithms. - Work side-by-side
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within
Essential Duties and Responsibilities: - Manage day-to-day operational aspects of a project and scope including facilitating and preparing all planning activities and artifacts. - Oversee and manage large multi-project programs including planning, organizing, staffing, leading, and controlling