Description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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.

Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.

The Patient Care Coordinator performs a variety of administrative and staff support duties for care management operations including but not limited to: Complex Care, Transitional care management, Disease Management, General Care Management, Transplant and Social Care programs. This position has expanded responsibilities responding to requests to support the referral process, incoming phone/fax inquiries, monitoring of associated program email inboxes and outbound coordination activities Supports system and care loading activities as directed. This position can resolve administrative problems and inquiries; supports the preparation of administrative documents and reports. Work involves the management of moderately complex systems, databases, and spreadsheets.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work on any of our 8-hour shift schedules during our normal business hours of 7:30am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime.

We offer on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers.
• Follow up on incoming and outgoing referrals, prior authorizations and including intake, notification.
• Assist the clinical staff with coordinating care needs.
• Handle resolution/inquiries from members and/or providers.
• Provides administrative support to ACM Nursing staff.
• Creates, maintains and processes system reports as required.
• Maintain regular and consistent attendance.
• Assists with the coordination of discharge planning, under the direction of the ACM nurse, as required.
• Communicates with members, family or caregiver when appropriate.
• Maintains confidentiality of all member information and business.
• Assists ACM staff with referrals for the appropriate Health Plan, State or Federal Disease/Condition
• Management programs as required.
• 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 outbound and incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff with ability to enter appropriate information within the clinical documentation system.
• Reviews member lists and assists in identification of medically complex members based on eligibility criteria for referral to care management staff.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• 2+ years of experience working within the health care Industry and with health care insurance
• 2+ years of experience in a clerical or administrative support background
• Experience with Microsoft Word, Microsoft Excel, Microsoft Outlook, and Adobe
• Knowledge of medical terminology
• Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work on any of our 8-hour shift schedules during our normal business hours of 7:30am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• 2+ years of work experience in a medical office OR medical field
• Experience Working in a call center
• General knowledge of managed care, third party payers, regulatory requirements and government entitlement programs
• Experience with computers and Windows based programs

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:

• Communication skills, particularly telephone skills
• Self-motivated with effective critical thinking skills
• Ability to work collaboratively
• Language Skills:
  • Effectively respond verbally and in writing to inquiries or complaints from customers, regulatory agencies or members of the business community
  • Communicate assertively as well as collaboratively with Management, plans, physicians, and patients
  • Effective present information to management team
• Reasoning Ability:
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where limited standardization exists
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
  • Ability to set priorities, define and implement effective workflow and processes

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $18 - $32 hourly based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.