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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Positions in this family include those responsible for functions in areas such as health services, clinical services and delivery of clinical care. Positions in this function include those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
This position is full-time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 8:00pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer 3 - 4 weeks of paid training (1 week of classroom training (virtual) and then a shadowing on-the-job training for a period of time until acclimated). The hours during training will be 8:00am to 5:00pm, Monday - Friday. Training will be conducted virtually from your home.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
- Extensive work experience within own function.
- Work is frequently completed without established procedures.
- Works independently.
- May act as a resource for others.
- May coordinate others' activities.
- Extensive work experience within own function. Applies knowledge/skills to a range of moderately complex activities.
- Demonstrates great depth of knowledge/skills in own function.
- Sometimes acts as a technical resource to others in own function.
- Proactively identifies solutions to non-standard requests.
- Solves moderately complex problems on own.
- Works with team to solve complex problems.
- Plans, prioritizes, organizes and completes work to meet established objectives.
- May coordinate work of other team members.
- Make calls to qualified members to provide information and answer questions about health plan programs.
- Provide “best-in-class” customer service to enrollees
- Meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
- Identify, qualify, and engage members into the most appropriate health and wellness programs to meet their needs.
- Effectively engage members that either qualify for our programs or are interested in learning more about what is offered.
- Accurate documentation of consumer interaction
- Appropriately follow all processes and procedures.
- Maintain engagement with all the customer requests to ensure high quality of customer service
Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you’ll also be the “go-to” resource for information. The flexibility to work evening hours will also be required.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 6+ months experience in an office setting or administrative role
- 2+ years of experience in a high-volume call center
- Proficient in Microsoft Word, Excel (creating, editing, saving) as well as Microsoft Outlook (customizing, navigating)
- Ability to work core business hours of 8:00am - 8:00pm CST, Monday – Friday at least 50% of shifts will be evening. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
- Sales experience
- Bilingual fluency in English / Spanish
- Healthcare or insurance benefits
- Experience in a hospital, physician’s office or medical clinic setting
- Clerical or administrative support background and/or working in a call center environment
Telecommuting Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
- Ability to connect directly into internet – via hard wire (either directly to modem or router)
Soft Skills:
- Excellent communication skills – both written and verbal.
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $19.47 to $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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