72 risk management jobs found in Philadelphia, PA

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) As a Telephonic Case Manager RN (NICU/Peds) with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!                                                                                Work...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) We’re making a strong connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that’s driving the health care industry forward.  As a Telephone Case Manager RN with UnitedHealth Group, you’ll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of...

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. This is a Telephonic RN Case Manager position that will be supporting the Enhanced Family Support (EFS) Program in the one nurse model - providing case management support from fertility, maternity through post-partum. You’ll enjoy the flexibility to...

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) Actively participate in the overall risk management program for assigned CDOs. Promotes a culture of safety in all interactions with staff and clinicians at assigned CDOs, by focusing on development of positive relationships and non-punitive investigations and solutions to reported events. Responsible for proactively responding to adverse event reports, working with leaders and SMEs at assigned CDOs to investigate and resolve...

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) You've been working your way to this opportunity for some time now. You've learned to lead. You've built a deep expertise in health care network operations. You've set your sights on having more impact in more ways. It's time to join our leadership team and help UnitedHealth Group as we help make the health system more efficient and effective. You'll leverage your expertise and knowledge in new ways as you strike the balance between health care costs and resources.  As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader....

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) There comes a point when you're ready to take off the training wheels and start guiding others. If that's where you are today, let's talk about where you can be tomorrow with our leading, global health care organization. Provider networks across the health care system are becoming more efficient and effective everyday thanks to companies like UnitedHealth Group and people like you. Here's an opportunity to put your expertise to work in new ways as you help strike the balance between health care costs and resources. In this consultative role, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do,...

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) This role involved managing a product from application architecture standpoints. Envision cloud architecture for enterprise products and suggest cloud technologies to leverage for new business opportunities. You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Ownership of product architecture and design, responsible for NFR...

Our goals are to provide excellent service, utilize advanced technology, and proficiently deliver results. To accomplish these goals, we constantly seek individuals who look for ways to do things better. We are a company whose culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize performance to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. Medication risk management is TRHC's lead offering, and its cloud-based software applications, including EireneRx and MedWise, provide solutions for a range of payers, providers and other healthcare organizations. TRHC empowers our employees to provide excellent service, utilize advanced technology, and proficiently deliver results. Our 32Fundamentals are what we...

Are you looking for a meaningful career in a local business that has national brand support people recognize and trust? As an Insurance Sales Professional, you will help grow a local Allstate agency by engaging new prospects and building strong relationships in the community. You will apply insurance knowledge and sales skills to increase the customer’s understanding of the value of insurance and cultivate long-term relationships with trusted advice. Responsibilities: Achieve sales goals through generating new business and cross-selling existing customers Identify and qualify sales leads generated from a variety of sources Help protect customers by offering Allstate products that will meet their needs Serve your local community by helping them prepare for life’s uncertainties Educate prospective customers on how to protect their families and assets Provide a positive customer experience Job Qualifications: Strong interest in a sales career - At least 1...

Local Unit & Position Description Channel Partner Program Manager is responsible for ensuring that DNV channel partners are organized and managed to maximize loyalty and revenue potential. The position will also be responsible for developing contacts and approaching new potential strategic partners and promoting pertinent DNV Business Assurance products/services as per the established sales & marketing strategy, tactical plan, and marketing plan. The position will also be responsible for developing and managing loyalty programs. What You'll Do Identify prospective channel partners and actively work to recruit these partners to participate in applicable DNV referral and growth programs Develop relationships with channel partners and help build the regional plan while supporting the local sales people Work closely with marketing to build marketing plans targeting strategic partner groups Provide information to channel partners regrading new DNV programs,...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. At UnitedHealthcare , we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM This position will lead efforts for end to end capitated delegated (CapDel) operational issue resolution with a specific focus on data integration touchpoints with the delegates, including misdirected claims, authorization submissions, eligibility, provider remittance advice etc. This position will be responsible for partnering closely with our delegated provider partners, as well as, with internal teams to improve the provider and member service experience related to key...

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) The Inpatient Coding Compliance Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services.  Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification system.  Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and...

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others and start doing your life's best work.(sm) As the Environmental, Social and Governance ("ESG") landscape evolves and becomes increasingly important to UHG’s corporate strategy and reputation, external stakeholders (shareholders, regulators, customers), increasingly expect end-to-end controls, accuracy, consistency and accountability for ESG internal and external reporting processes across the enterprise.  The ESG Data & Process Excellence Analyst is responsible for ensuring the accuracy and integrity of UHG’s ESG metrics, key...

Job Brief Provide security strategy, security architecture assessments and reviews of enterprise projects for dentity Management Platforms Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. The Central Support Operations Coordinator serves as the main point of contact for healthcare providers and members that are receiving post-acute services. In addition, the Central Support Operations Coordinator role serves as administrative (non-clinical) support for the remote clinical services team.  This role is responsible for providing direct support to the multi-disciplinary team to anticipate and plan for continuum of care and discharge needs and communication with providers and clients.  The Central Support Operations Coordinator is responsible for processing inbound and outbound communication (i.e. telephonic, fax, electronic notifications and letters), maintaining accuracy of database documentation and the completeness of the medical record and naviHealth database. This position is full-time (40 hours/week) Sunday - Saturday. Employees are required...

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 by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide comprehensive program financial support to leadership including capital budget management, detailed financial modeling, and other control processes. This includes the following:  ACE/Drive to 5 Business Case Support and analysis EIS Monthly and Quarterly Financial...

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best.  This Dental Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the...

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others and start doing your life's best work.(sm) The Client Engagement Manager (CEM) will be responsible for the operational management of M&A People projects. This role will support the Client Engagement Leader (CEL) working in collaboration with the People Team Centers of Excellence (COE)s and acquired entity with overall responsibility as follows: Day-to-day operational management of a transaction from diligence through People integration Strategically partners with client engagement lead and key stakeholders to guide...

Well-regarded, national financial institution with exceptional compensation and benefits! Remote This Jobot Job is hosted by: Eric Shaner Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $110,000 - $140,000 per year A bit about us: Remote, preferably located on the East Coast (Philadelphia, Baltimore, DC general area) as needed/very limited onsite during the QTR We have extremely low attrition...people stay here, because we have something special. Mindset of support! National financial services company. Well documented growth and strong 5 year plan for growth! Flat organization with a career path designed around you. Extremely lucrative pay structures. Flexible work schedules. We are a growing, national financial services company that is seeking a technical Internal Audit Manager to join our Accounting team, supervising 3 people. As a member of the Audit team, you will primarily be responsible for leading /...

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) Positions in this function provide legal advice and services on issues concerning the rights, obligations, risks and privileges of the organization. Acquire deep knowledge of the industry and the specific business practices of the Pharmacy Programs Team within UnitedHealth Group so as to best advise senior business leaders. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.  Primary Responsibilities: Support product development, benefit interpretation processes, and pharmacy benefit management...