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.

This position is full time. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.

We offer 3 weeks of paid training. The hours during training will be 8:00am - 5:00pm, Monday - Friday.Training will be conducted virtually from your home.

Primary Responsibilities:

• This is a field-based position, and you will be required to obtain in-person member signatures and gather physician attestations required for waiver LOC (Level of Care).This will be a daily expectation for this role.
• Manage the intake of members or the admission/discharge information post notification
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
• Handle resolution/inquiries from members and/or providers. This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone.

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
• 1 years of customer service experience analyzing and solving customer problems
• Must be willing to work a field-based position that will require daily in-field responsibilities within DC market.
• Proficiency with Microsoft Word and Microsoft Excel (ability to create, edit, save and send documents and spreadsheets)
• Ability to work full time. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Call center experience
• Knowledge of ICD-9 and CPT codes
• Clerical or administrative support background
• Experience working in a metric-driven work environment
• Experience working with Medicare and/or Medicaid Services
• Experience working within the health care Industry and with health care insurance
• Reside in the District

Soft Skills:

• Ability to work independently
• Strong time management skills
• Must be able to type and talk at the same time and navigate through multiple screens

Washington, D.C. Residents Only: The hourly range for this is $16.00 - $28.27 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.

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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