Provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management p

The Medical Assistant will increasingly gain responsibility for providing assistance to the healthcare clinician by providing direct patient care Obtains patient histories and vital signs and records accurately in the Electronic Medical Record Prepares patients for examination and treatment and documents chief complaints Retrieves laboratory and radiology test results and

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing Understands and complies with long term care policies and procedures, including those that regulate nursing facilities and assisted living communities Establishes and maintains effective relationships with members and their legal representatives, faci

ProHealth Physicians, part of the Optum family of businesses, is seeking a motivated and patient centric Family Medicine trained Primary Care Physician to join our growing practice in Groton, Connecticut . Optum is a clinician led care organization that is changing the way clinicians work and live every day. At Optum, you'll have the clinical resources, data and support o

ProHealth Physicians, part of the Optum family of businesses, is seeking a motivated and patient centric Pediatric Primary Care Physician to join our growing practice in Branford, Connecticut at Branford Pediatrics . Optum is a clinician led care organization that is changing the way clinicians work and live every day. At Optum, you'll have the clinical resources, data an

Identify and develop strategic opportunities to enhance client satisfaction and drive business growth Formulate and execute strategies to ensure client compliance with Federal and State regulations governing Medicare and Medicaid programs Collaborate with subject matter experts (SMEs) to develop tailored Medicare strategic initiatives, including initiatives related to STA

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

Serve as single point of contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum's internal processes and priorities, and other Optum initiatives, as applicable Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to dev

Reading and interpreting provider contracts, or other pricing artifacts, to complete provider configuration design templates Loading provider contracts into Facets (using Facets or NetworX capabilities) Extracting and analyzing pricing data to help assess load accuracy and to resolve provider pricing inquiries and/or pended claims Complete quality control measures to ensu

Collaborate with executive leaders and business units to identify and understand their reporting and analytics needs, ensuring alignment with organizational goals. Manage the deployment of cloud based data solutions and business intelligence tools to enhance reporting capabilities and support data driven decision making. Design and develop efficient data pipelines, data w

Develop, perform and manage the analyses of business and financial metrics as well as performance measures for all capital and other labor costs within OptumRx Information Systems Develop and maintain financial reports to clearly communicate actual results, forecasted performance, and variances to plan, forecast and budget for $300M in annual spend Develop, perform and ma

Provide comprehensive women's health services to our community through the provision of office services, deliveries, and inpatient/outpatient surgical procedures Monday Friday clinic/office schedule with rounding time built into the schedule Full scope GYN practice with major and minor procedures including minimally invasive surgeries with robotics Excellent access to GYN

Screen and assess patients for common mental health and substance abuse disorders Provide treatment for a variety of mental health conditions using treatment approaches including cognitive behavioral therapy, dialectical behavioral therapy, and other evidence based methods Systematically track treatment response and monitor patients for changes in clinical symptoms and tr

Screen and assess patients for common mental health and substance abuse disorders Provide treatment for a variety of mental health conditions using treatment approaches including cognitive behavioral therapy, dialectical behavioral therapy, and other evidence based methods Systematically track treatment response and monitor patients for changes in clinical symptoms and tr

Provide comprehensive women's health services to our community through the provision of office services and inpatient/outpatient surgical procedures Monday Friday clinic/office schedule with rounding time built into the schedule Full scope UroGYN practice with major and minor procedures including minimally invasive surgeries with robotics Excellent access to GYN Oncology,