UnitedHealth Group
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.
This position is full-time (40 hours/week) Sunday – Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 11:00pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer weeks of on-the-job training. The hours during training will be 6:00am – 11:00pm CST, Sunday – Saturday.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Act as the escalation point for members requesting to speak to a supervisor. You are expected to be as knowledgeable as supervisors and are empowered to resolve issues with the urgency and impact as a supervisor.
Own complex problems through to resolution on behalf of members regarding pharmacy benefits, eligibility and claim, and other member concerns regarding their benefits.
Reduce contact rate by educating members about their pharmacy benefits and how to maximize their plan.
Research complex issues across multiple databases and collaborate with internal and external resources to solve complex/escalated issues.
Build and maintain business partnerships across all lines of business for quick and accurate resolutions to escalated member inquiries.
Act as subject matter expert (SME) to provide real time support to team members needing additional guidance in solving member issues or answering questions.
Provide coaching to staff when errors or preventable issues are identified when handling escalated issues. To include providing best practice for optimizing available resources and tools in real time.
Exercise independent discretion and judgment to solve member issues efficiently, accurately and with a high degree of customer satisfaction.
De-escalate complex and stressful calls, helping members understand how and why they should take action and/or change how they interact with their pharmacy benefits.
Communicate ongoing member issues and outcomes to leadership.
Identify root cause to members issue and communicate gaps in processes and work closely with other departments for process improvement.
Positions in this function are responsible for first-level response and resolution of escalated issues with external and internal customers. Responsible for the overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.
Follow up with members to provide resolution as needed.
Basic, structured, standard approach to work.
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
Currently a part of Optum RX role
Ability to work any of our 8-hour shift schedules during our normal business hours of 6am – 11pm CST. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications:
1+ years in OptumRx Customer Service Advocate Lead role
3+ years of Customer Service experience
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
Soft Skills:
Employees in this role must be highly experienced in member tools, claims processing, benefit interpretation, detailed benefits/claim support and complex issue management to interpret situations and proactively address complex member issues
Ability to de-escalate an issue to regain the members’ trust and confidence quickly
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $23.22 – $45.43 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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