UnitedHealth Group
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Talk about meaningful work. Talk about an important role. Let’s talk about your next career move. UnitedHealth Group is offering an innovative new standard for Health advocacy. Advocate4Me is a simplified service providing support for a family’s end to – end Health and Benefit needs through a single point of contact. Advocate4Me connects consumers to a trusted advocate who helps them get the most out of their benefits and obtain the best care. Due to expansion of this innovative program, we are seeking Licensed Practical Nurses who share our passion for helping people live healthier lives to join our team. It’s an inspiring role and it can inspire your career. For those who want to reinvent the future of healthcare, here’s your opportunity. Find out more about these opportunities to do your your life’s best work.SM
As an Elite Customer Service Advocate for UnitedHealthcare, you’ll be responsible for building trust with members across their health care lifecycle. This function is responsible for assisting members with medical and pharmacy benefits, eligibility, claim resolution, triaging dental and vision issues, assisting with plan selection and enrollment, and improving health care literacy. This function is also responsible for multiple types of claim payment adjustments, including closed claims and denied claims. This function is expected to identify opportunities to resolve member issues timely.
This position is full – time (40 hours / week), Monday – Friday. Employees are required to work any 8-hour shift schedule between the hours of 6:00 AM – 8:00 PM PST (Pacific Standard Time). It may be necessary, given the business need, to work occasional overtime.
We offer 8 weeks of training. The hours during training will be 8:00 AM – 4:30 PM PST from Monday – Friday. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Watch this to understand the expectations of being a remote worker with UnitedHealthcare. This features some of our Consumer Service team members sharing insights on the best parts of their job, as well as the challenges. You’ll also hear about the culture and career pathing opportunities at UnitedHealthcare.
Primary Responsibilities:
Provides premium level service, removing burdens and providing end-to-end resolution for members
This includes, but is not limited to: Clinical, Financial Decision Support, Behavioral Support, Claims inquiries, and more
Provide single point of contact for the member for highly designated or dedicated UHC national or key account insurance plans
Respond to and own consumer inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility, claims, financial spending accounts, correspondence, OptumRx Pharmacy, Optum Behavioral Health and self-service options
Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow – up with the member
Educate members about the fundamentals and benefits of consumer – driven health care topics to include managing their health and well – being so they can select the best benefit plan options and maximize the value of their health plan benefits
Advocate and intervene with care providers (doctor’s offices) on behalf of the member to assist with appointment scheduling, billing concerns, and coverage determinations
Assist the member with resolution as their advocate with 3rd party vendors
Assist members in navigating myuhc.com and other UnitedHealth Group websites or applications utilizing remote desktop system capabilities
Communicate and keep consumer informed through the means in which they prefer, i.e., Phone Call, secure messaging, e – mail or chat
Research complex issues across multiple databases and work with support resources to resolve member issues and / or partner with others to resolve escalated issues.
Meet the performance goals established for the position in the areas of: conversation effectiveness, call quality, member satisfaction, first call resolution, efficiency and attendance
Additional Responsibilities:
Answer up to 30 to 60 incoming calls per day from members of our health / dental /vision / pharmacy plans
Performs claims adjustments / dollar payments to providers and / or members ultimately impacting UHC costs or commercial account costs
Effectively refer and enroll members to appropriate internal specialists and programs, based on member’s needs and eligibility using multiple databases
Interpret and translate clinical / medical terminology into simple – to – understand terms for members
Respond to and resolve on the first call, member service inquires and issues by identifying the topic and type of assistance the caller needs, such as; benefits, eligibility and claims, financial spending accounts and correspondence
Navigate through multiple platforms and databases to retrieve information regarding medical plans, prescription plans, flexible spending accounts, health reimbursement accounts, vision plans, dental plans, employer – based reward plans, claims submissions, clinical programs, etc.
Must remain current on all communicated changes in process and policies / guidelines
Adapt to all process changes quickly, and maintain knowledge of changes at site level and entity level by utilizing all available resources
Resolve member service inquiries related to:
Medical benefits, eligibility and claims
Terminology and plan design
Financial spending accounts
Pharmacy benefits, eligibility and claims
Correspondence requests
Educate members about the fundamentals of health care benefits including:
Managing health and well – being programs
Maximizing the value of their health plan benefits
Selecting the best health plan to meet their health needs
Choosing a quality care provider and appointment scheduling
Premium provider education and steerage
Pre – authorization and pre – determination requests and status
Benefit interpretation
Self – service tools and resources
Healthcare literacy (correspondence and literature interpretation)
Work directly with site leadership to remove process barriers
Navigate multiple online resource materials and follow defined process for issue handling
Maximize use of community services, support programs, and resources available to member
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
6+ months of Advocate4me T1 or T2 benefit experience
Currently works within E&I Ops – Consumer Services
Ability to work any full – time (40 hours / week) 8-hour shift schedule between the hours of 6:00 AM – 8:00 PM PST (Pacific Standard Time) from Monday – Friday
Preferred Qualifications:
Health Care / Insurance environment (familiarity with medical terminology, health plan documents, OR benefit plan design)
Social work, behavioral health, disease prevention, health promotion, and behavior change (working with vulnerable populations)
Sales OR account management experience
Customer service experience
Proficient in translating healthcare – related jargon and complex processes into simple, step – by – step instructions members can understand and act upon
Reside within the Pacific Time Zone
Telecommuting Requirements:
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
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for this is $19.47 – $38.08 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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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UnitedHealth Group
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