Perform complex financial modeling, data analysis, and business planning in support of the Home Delivery Pharmacy's (HDP) forecast, budget, and long range plan Collaborate with key business partners across the organization to support forecast assumptions, share insights and scenario sensitivities Delivers weekly projections and variance analytics on business performance w

Utilize the Preferred One medical criteria and those of other regulatory bodies, (i.e. NCQA, DOH), the exempt and focused review programs, and the patient's benefit plan summary to perform medical necessity, level of service and appropriateness review Perform inpatient and outpatient pre admission, concurrent review and decision support based on medical necessity, appropr

Lead and coordinate client communications. Focusing on providing clear and effective solutions to technical questions, while ensuring customer satisfaction Liaise with our internal stakeholders (senior leadership, legal, privacy teams, technical product teams, sales teams) to help obtain appropriate approvals and drive critical decision making Execute creative problem sol

Resolves highly complex business problems that affect clinical processes and functional requirements Participates in the development of measurable clinical business, affordability, and quality goals Identifies and prepares recommendations for cross functional/cross CDO medical management process improvements and opportunities Leverages data from multiple sources and analy

Build analytics tools that utilize data to provide actionable insights into customer acquisition, operational efficiency, and other key business performance metrics Build, maintain, and production support of analytics tools in Power BI Design, build, and launch efficient and reliable data pipelines in Azure Data Factory and Snowflake Extract, Transform, and Load data from

Provide coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported Maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96% coding accuracy rate required You'll be rewarded and recognized for your performance in an environment that will

This role will provide coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. Must maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96% coding accuracy rate required. You'll be rewarded and recognized for your performance in an

Conduct issue resolution and provide live support for users within Optum Health credentialing teams on the credentialing software platform Manage and monitor internal ticketing process for user support and enhancement requests Engage with vendor to identify repetitive, high volume issues Work with the user population to identify usability enhancements and engage with vend

Serve as a member of the operations senior leadership team and advise executives on external trends, problems, and activities to facilitate both short and long range strategic plans to improve operational performance and enhance growth. Set the vision and strategic plan for OptumRx PBM operations & client services and support scaled operations through solid partnership ac

Overview Find Your Passion and Purpose as a Home Health LPN Licensed Practical Nurse Sign On Bonus $5,000 Rate $30 $39 / hour Territory Eden Prairie and surrounding areas Schedule 0.8 or 1.0 available Reimagine Your Career in Home Health As a medical professional, LPN Licensed Practical Nurse , you know that what you do impacts you as much as your patients and their famil

Twin Cities Orthopedics

Senior Software Engineer, Digital Health Why Join Bracco Medical Technologies? We care as much about our employees as we do our patients. Our culture fosters a work environment where employees can thrive, be passionate and have fun along the way. Each member of the Bracco Medical Technologies team has the power to make a difference......every day! Position Description The

Starkey Hearing is looking to add an NPI Sourcing Manager to provide cross commodity sourcing/supply management leadership for New Product Introduction teams and/or technology and research projects at our global headquarters in Eden Prairie, MN. You will serve as project manager to ensure integration and execution of best in class supplier engagement processes to deliver

As we look back on Pride Institute's almost 38 year history of providing our clients with an inclusive and accepting place for recovery through evidence based treatment for substance abuse, sexual health and mental health, we realize that Pride Institute's services and advocacy are needed now more than ever! Our Residential Treatment Center (RTC) staff in Eden Prairie and

DESCRIPTION / PRIMARY PURPOSE OF JOB The Senior Mechanical Designer, under direct supervision, is responsible to design and develop highly complex product and component concepts for release to production in a manner to ensure superior performance, quality, manufacturing, and cost requirements for standard or custom products. JOB RESPONSIBILITIES/RESULTS Conceives highly co