Prior Authorizations Analyst - Worcester, MA

Reliant Medical Group, part of the Optum family of businesses, is seeking a Prior Authorizations Analyst to join our team in Worcester, MA. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

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 - 4:30pm EST. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

If you are within a commutable distance to the office at 100 Front Street, Worcester, MA 01606, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Contacts patients for the purpose of achieving established outreach program goals. This may include contacting patients via telephone, email and/or direct mailings to stress the clinical importance of receiving their recommended lab work and attending their medical appointments
• At the request of a Clinician, may place lab order and/or schedule appointments in electronic medical record system
• Generates reports using Healthy Planet Registry in Epic EMR to identify patients who require additional labs to be ordered as well as identifying patients who are over-due for labs
• Consults with clinicians to determine required population reports and/or patient lists for analysis and outreach
• Communicates and collaborates with care coordination staff to optimize patient care, and supports patient care plans by assisting with linkages to, coordination of, and monitoring identified service needs
• Recognizes and reports data inconsistencies, gaps in performance, and opportunities to improve results to appropriate personnel

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
• Ability to travel up to 100% of the time
• Ability to work full-time, Monday - Friday, in any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm EST, including the flexibility to work occasional overtime, based on the business need

Preferred Qualifications:

• 1 years of experience in healthcare
• Knowledge and understanding of medical terminology
• Proficiency with electronic medical record systems
• Microsoft Office Suites
• Proficient with data manipulation including the ability to develop spreadsheets, build data tables and extract data

Telecommuting Requirements:

• Reside within a commutable distance of 100 Front Street, Worcester, MA 01606
• 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

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

The hourly range for this role is $16.88 to $33.22 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.

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.

#RPO

Salary : $17 - $33