Jobs at Optum

The RN Care Manager assesses members, develops and manages individualized person-centered service plans, coordinates medical and community services, communicates with care stakeholders, and advocates for members and families. The role supports individuals with complex needs across the continuum of care, using UAS-NY and community-based resources to ensure timely, appropriate, and coordinated services.

Own the product lifecycle for consumer-facing web and mobile healthcare experiences. Translate customer needs, business objectives, and technical constraints into requirements, user stories, acceptance criteria, and prioritized backlogs. Coordinate engineering, UX, analytics, architecture, and business stakeholders from discovery through launch, while managing dependencies, risks, and performance monitoring. Use product data, consumer feedback, analytics, and AI tools to improve digital experiences and support measurable outcomes.

Drive territory sales for IVIG infusion services by generating new specialist referrals, developing healthcare provider relationships, executing territory business plans, identifying target customers, and collaborating with intake, operations, nursing, and manufacturing partners. The role requires educating customers on disease states and treatment options, supporting patient-centered outcomes, attending occasional evening and weekend events, and traveling to clinics and hospitals.

Provides in-person bilingual member services for Medicare and DSNP health plan members in English, Cantonese, and Mandarin. Explains benefits and policies, resolves claims and billing issues, fulfills material requests, provides interpretation, and assists with government program applications. Supports quality programs, outreach calls, educational seminars, community events, and Medicare enrollment and sales activities. The role is fully onsite in Flushing, New York, with occasional local travel and required health licensing after six months.

Provides direct patient care and telephone support in an internal medicine/family medicine practice. Escorts patients, records vital signs, performs vision screenings and selected laboratory tests, assists providers with examinations and procedures, prepares e-prescriptions, processes specimens, and cleans clinical equipment. Coordinates with physicians, nurses, and other care-team members to support efficient, patient-centered care.

Provides direct and telephone patient care in an internal and family medicine setting. Escorts patients, records vital signs, performs vision screenings and selected laboratory tests, assists providers with examinations and procedures, prepares e-prescriptions, processes specimens, and cleans instruments. Coordinates with the care team to address patient needs and support seamless care delivery. Requires at least one year of clinical or medical office experience and recent phlebotomy experience.

Supports actuarial analyses for provider evaluation, network strategy, premium designation, and healthcare affordability. Analyzes claims, enrollment, provider, utilization, and financial data; builds and validates models, datasets, dashboards, and reporting processes; develops methodologies; and communicates recommendations to cross-functional stakeholders. The role also supports peer review, governance, documentation, workflow automation, reproducibility, and scalable analytics.

Provides remote telephonic and telehealth care to members across acute, chronic, behavioral, and complex conditions. Conducts assessments, documents encounters in the EMR, coordinates care across providers and facilities, manages treatment plans, supports advanced care planning, and addresses quality and cost-effectiveness goals. Requires rotating evening, overnight, weekend, and holiday coverage, with a minimum commitment of 20 hours weekly.

Provides prescription processing and medication distribution across Genoa pharmacies in Brooklyn, Queens, and Long Island. Counsels customers on medication use, delivers excellent service, ensures compliance with New York pharmacy laws, administers permitted immunizations, and performs customary pharmacy duties. Requires a New York pharmacist license, immunizer certification or willingness to obtain it, reliable transportation, and a valid driver’s license.

Field-based role managing provider groups to close gaps in care, collect/chart data, educate providers on Medicare quality programs, ICD-10/CPT II coding and documentation, and improve HEDIS/Stars performance. Requires frequent travel within a local territory, relationship building, data entry/analysis, and adherence to HIPAA and network requirements.

Leads provider network development and contracting for competitive, stable, affordable healthcare networks. Negotiates provider agreements, evaluates contract performance, applies reimbursement and incentive models, analyzes financial and market data, and develops network and contracting strategies. Maintains relationships with skilled nursing facilities and business partners while supporting Medicare, managed care, employer, individual, community, and state products. The role requires network management, medical cost, provider contracting, financial modeling, and reimbursement expertise, with remote work during EST hours and travel to New York.

Manages employer and group client accounts, serving as the primary contact for service delivery, provider network administration, claims issue resolution, financial reporting, renewals, and client-facing presentations. Coordinates cross-functional teams to implement client initiatives, resolve complex claims issues, maintain accurate provider rosters and fee schedules, and support account strategy. The role requires direct healthcare client service experience, a New York health insurance license or willingness to obtain one, and hybrid onsite work in New York City.

Manages a portfolio of large national healthcare accounts, driving retention, growth, profitability, renewals, and strategic account plans. Builds relationships with customers, brokers, consultants, and senior stakeholders; leads negotiations, client presentations, and RFP efforts. Coordinates internal teams to deliver client solutions, monitors financial performance, provides market feedback, and applies healthcare, underwriting, pricing, and analytical expertise.

Field-based bilingual Account Manager responsible for enrolling eligible members in UnitedHealthcare’s Essential Plan, developing B2B and community partnerships, presenting health plan information, closing sales, and managing a territory pipeline. The role requires frequent local travel, relationship building, event and lead tracking, member support, and accurate communication of healthcare benefits and processes. Candidates must be bilingual in English and Russian and able to work independently across varied community settings.

Leads enterprise-wide risk adjustment strategy and operations across Medicare Advantage, Medicaid, and commercial contracts. Oversees coding, chart review, clinical documentation improvement, provider engagement, analytics, audit readiness, and regulatory compliance. Partners with clinical, finance, actuarial, legal, compliance, and provider stakeholders to improve risk capture, RAF performance, coding accuracy, and financial outcomes. Builds standardized workflows and leads teams across coding, CDI, analytics, and risk operations.

Supervise non-clinical clinic staff, manage staffing and productivity, administer HR processes, ensure contract and quality performance, oversee inventory, scheduling, reporting, and vendor/customer relations, and serve as escalation point for technical and operational issues.

Develop and manage provider networks by negotiating contracts, managing unit cost budgets and financial models, ensuring network adequacy, maintaining contracts, implementing regulatory changes, and resolving contract administration issues with providers and internal stakeholders.

Provides customer service to members, brokers, and benefits administrators through inbound and outbound calls. Resolves eligibility, enrollment, billing, and benefits questions; supports small-group renewals; explains renewal processes and plan changes; coordinates with enrollment teams; and maintains service, productivity, quality, and schedule standards. The role requires fluent English, Cantonese, and Mandarin, strong problem-solving ability, and proximity to Flushing, New York.

Provides direct pediatric patient care and supports physicians and nurses during exams and office procedures. Performs vital signs, vision screenings, laboratory testing, specimen processing, instrument preparation, e-prescription preparation, patient rooming, and telephone or in-person care coordination. Follows clinical standards and protocols, communicates patient and family needs, and assists with ensuring seamless care delivery.

Provides advanced clinical care to high-risk patients in nursing homes, senior housing, assisted living, and rehabilitation settings. Responsibilities include comprehensive assessments, medication reconciliation, physical exams, screenings, documentation, care-team collaboration, advanced illness and care-planning discussions, and patient and caregiver education. The role requires appropriate NP or PA certification, state licensure, DEA authority, a driver’s license, and reliable transportation.