Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealth Care Community & State.We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.This is not an entry level position. You will be providing care coordination telephonically completing assessments and documentation within a clinical system while multitasking other applications gathering information to support member's needs. Must have excellent typing, writing and grammar skills. Primary responsibilities are telephonic case management and some administrative responsibilities for the clinical department related to member care. This is a very fast-paced environment working with 10+ people. We are looking for a team player who is goal oriented, self-motivated, takes initiative and is willing to learn in a fast environment.Primary Responsibilities: Provide exceptional customer serviceManage administrative intake and data entry for clinical team of membershipWork with providers and / or the clinical team to manage request for long term and respite servicesManage notifications, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census rolesReceive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triageAssist the clinical staff with setting up documents / triage cases for Clinical Coverage ReviewProcess and distribute custom reports to providers and clinical staffMultitasking with multiple platforms and applicationsInbound/outbound phone calls to providers other internal departments to assist with notifications, documentation
Required Qualifications: High School Diploma or GED1+ years of experience using the telephone and computer as primary instruments2+ years of healthcare administration / Healthcare research administration experienceExperience utilizing a PC computer to navigate different computer systems and experience utilizing Microsoft Excel, Microsoft Word, and Microsoft Outlook to perform job functions.Preferred Qualifications:Bachelor's Degree or higherExperience with medical terminologyClaims and / or healthcare insurance experienceCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. 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.Keywords: UHG, Waltham,MA, customer service, healthcare, telephonic, patient interaction, field based, advocacy
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.