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.
This position is full-time, Monday - Friday with a once a month rotating Saturday shift . Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00 am - 6:00 pm CST. It may be necessary, given the business need, to work occasional overtime and weekends.
We offer 7 weeks of paid on-the-job training. The hours of the training will be aligned with your schedule.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsabilities:
- Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations.
- Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g. phone queue, TruCare, portal, claim queue, department e-mail box or Rightfax.
- Coordinates and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes UM requests via all communication venues; as well as administrative preparation for clinical staff.
- Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members.
- Performs daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in “pend” and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations.
- Participates in market Patient Care Committees: prepares agenda, documents minutes and distributes to appropriate venue
- Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable.
- Completes timely data entry of in-bound and/or out-bound call member contact information into software applications (Claims Database, TruCare, etc.).
- Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs.
- Provides excellent customer service by serving as a resource to all internal and external customers.
- Attends required meetings and participates in adhoc committees as needed.
- Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies.
- Maintains monthly logs for Notice of Medicare Non-Coverage (NOMNC) per delegation requirements and distributes to management. Performs all other duties as assigned.
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
- Must be 18 years of age OR older
- 2+ years of administrative support experience
- Advanced knowledge of Microsoft Office products, including Microsoft Word, Microsoft Excel and Microsoft Outlook
- Knowledge of medical terminology
- Ability to work any shift between the hours of 9:00 AM - 6:00 PM CST from Monday - Friday with a once a month rotating Saturday shift, including the flexibility to work occasional overtime and weekends based on business need
Preferred Qualifications:
- 2+ years of experience in a physician’s clinic OR hospital
- Certified Medical Assistant training OR certification
- Additional years of experience working in a medical care setting as a receptionist OR medical assistant
- Bilingual fluency in English and Spanish
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
Soft skills:
- Ability to work independently, with some supervision and direction from manager
- Must Possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
- Must Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
- Must Adhere to all department / organizational policies and procedures
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $16.54 - $32.55 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 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.
