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 Healthcare 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 .
Positions in this function (with the exception of Healthcare Services Coordinator ) require education / certification / licensure other than an RN, such as BSW, MSW, Respiratory Therapist, Dietician, Nutritionist, Occupational Therapist, etc. Positions are responsible for providing clinical and medical management services, including case management, health assessments, interventions, and discharge planning. May identify, coordinate or provide appropriate levels of care under the direct supervision of an RN or MD. This function does not include Health Coach, Health Educator and Health Advocate roles that do not require an RN. Those roles are found in the Wellness Coach Management function.
Assisting in the review of medical records to highlight Star opportunities for the medical staff
Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members
Assist members in navigating their network of providers by assisting with follow-up and specialist appointments as needed
Assist with program eligibility and appropriate referrals to remove barriers in care
This may include referrals to case management and / or social worker services
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 patients and / or providers regarding appointments
Communicate scheduling challenges or trends that may negatively impact quality outcomes
Activities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activities
Track appointments and document information completely and accurately in all currently supported systems in a timely manner
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
Optimize customer satisfaction, positively impact the closing of gaps in care and productivity
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 and will be supervised by licensed and / or certified staff
Manage time effectively to ensure productivity goals are met
Moderate work experience within own function
Some work is completed without established procedures
Basic tasks are completed without review by others
Supervision / guidance is required for higher level tasks
Role assists in coordinating health services and does not write care plans
High School Diploma or GED
2+ years of customer service experience
1+ years of a healthcare background with medical terminology familiarity of clinical issues
1+ years of working experience with ICD- 9 / 10 and CPT Codes
1+ years of working experience with Microsoft Word (edit, save) and Microsoft Outlook (create emails and folders, meetings) Preferred Qualifications:
Previous EMR experience Careers with OptumInsight . Information and technology have amazing power to transform the Healthcare industry and improve people’s lives. This is where it’s happening. This is where you’ll help solve the problems that have never been solved. We’re freeing information so it can be used safely and securely wherever it’s needed. We’re creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work .
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.