Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Responsible for timely and accurate processing of work that supports the administrative requirements of the Care Management department, including Utilization, Case and Disease Management. Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment

Primary Responsibilities:

• Provide direct customer service for care management department including responding to incoming calls to department. Finds solution or refers caller to appropriate team member for assistance
• Complete outreach calls to patients identified as eligible for Case Management and Disease Management programs
• Provides verbal confirmations and written documentation of determinations regarding benefit eligibility, authorizations for inpatient admissions and outpatient precertification and/or prior authorization requests
• Performs electronic eligibility and benefits verification
• Reviews and routes electronic documentation to clinical staff as needed
• Coordinates medical appointments with provider clinics
• Assists with reporting, writing/reviewing workflows, and other projects
• Maintains up to date knowledge of insurance requirements including in network and out of network, and management of prior authorization process.
• Attends departmental meetings and provides constructive recommendations for areas of improvement.
• Performs 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 or GED equivalent
• 1+ years of experience in a customer service role
• 6+ months of experience in a healthcare environment
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
  

Preferred Qualifications:

• Health insurance experience
• Knowledge of medical terminology
• Skilled with MS Office software applications
• Attention to detail
• Ability to multi-task and work under pressure
• Self-motivated, strong computer skills
• Excellent communication, interpersonal, organization and customer service skills
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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