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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.
We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.
Primary Responsibilities:
Assist in the review of medical records to highlight Star opportunities for the medical staff.
Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities.
Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data.
Track appointments and document information completely and accurately in all currently supported systems in a timely manner.
Optimize customer satisfaction, positively impact the closing of gaps in care and productivity.
Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed
Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities.
Answer inbound calls from members and/or providers regarding appointments.
Communicate scheduling challenges or trends that may negatively impact quality outcomes.
Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs.
Provide ongoing support and education to team members and assist in removing barriers in care.
Manage time effectively to ensure productivity goals are met.
Ability to work independently in virtual setting. Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise.
Identify and seek out opportunities within one's own work flow to improve call efficiency.
Adhere to corporate requirements related to industry regulations/responsibilities.
Maintain confidentiality and adhere to HIPAA requirements.
Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level
Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events
Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts.
Field based activities require the abilities to support appropriate targeted providers.
Other duties, as assigned.
Weekly commitment of 75% travel for business meetings (including client/health plan partners and provider meetings) and 25% remote work
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
1+ years of customer service experience within healthcare, insurance, social services, education, or government/state agencies.
1+ years of working experience with Microsoft Word (create, modify, and send documents)
1+ years of working experience with Microsoft Outlook (create, modify, and send emails)
Ability to travel up to 50% for field-based work.
Ability to work onsite at providers office twice a week when required in Charleston, SC.
Ability to work remotely and traveling to local healthcare providers as needed.
Reside within a commutable distance of Charleston, SC.
Ability to keep all company sensitive documents secure (if applicable)
Dedicated work area established that is separated from other living areas that provides information privacy
Residing in a location that can receive a high-speed internet connection (additional information on UnitedHealth Group approved internet providers and restrictions will be provided)
Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm.
Preferred Qualifications:
Experience working in a physician, provider, and/or medical office
Experience with navigating, filtering, and analyzing reports in Microsoft Excel
1+ year of working experience with ICD- 9/10 and CPT Codes.
1+ year of working experience with and knowledge of HIPAA compliance requirements.
Medical Assistant experience
LPN
1+ years of telephonic customer service experience
EMR and HEDIS knowledge and experience
Soft Skills:
Demonstrated ability to identify with a consumer to understand and align with their needs and realities.
Demonstrated ability to perform effective active listening skills to empathize with the customer to develop a trust and respect.
Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done to achieve a goal(s).
Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
Good Attendance Record.
Strong data entry skills
The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. 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.
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 i_ _s 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.
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