You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
A Healthcare Advisor is a single point of contact for consumers for all things related to health and wellness benefits. A Healthcare Advisor helps members navigate the health care system; including helping with claim and benefits questions, helping members find quality doctors and schedule appointments; connecting consumers with health and wellness resources; and coaching members to make better health choices by providing education. A Healthcare Advisor creates an ongoing and lasting impression of the Optum consumer experience.
- Handle inbound and outbound calls with an emphasis on excellent customer service in a call center environment.
- Own member issues, questions, concerns, and see them through to resolution.
- Respond to members and providers in a polite and courteous manner,with patience, empathy, care, compassion, and sincerity in voice tone and pace.
- Assist members with medical and pharmacy benefits, medical plan overview, behavioral health inquiries, claims, provider search and prior authorization.
- Provide member education on HAS, FSA, HRA, and other financial accounts.
- Serve as a Health Care Advisor, going above and beyond for consumers, creating a memorable consumer experience, and providing expert, proactive service to members by:
- Finding creative ways to do more than what the member expects
- Delighting each member by meeting their unexpressed needs
- Leaving each person feeling confident and cared for
- Education to help simplify the healthcare system and validate members understanding of next best actions
- Advise members in choosing healthcare providers that meet and exceed consumer needs
- Educate members on clinical and wellness resources they can take advantage of to manage a health condition/disease or reach a wellness goal
- Provide education to members to assist in understanding benefits, terminology, claim resolution and Explanation of Benefit interpretation
- Serve as an advocate by responding to, resolving and escalating complex claim issues with internal and external resources
- Initiate telephone calls to internal sources, membership, providers, and other claim payers to gather data and determine resolution to claim issues
- Refer qualified members into Wellness and clinical programs
- Solve problems systematically, using sound business judgment, and following through on commitments
- Consistently meet established productivity, schedule adherence, meeting metric expectations, and quality audit standards
- Work with cross carries to ensure member follow up and resolution. (cross carrier functions)
- Work with providers and plans to help ensure critical info is being relayed timely between the plan and the provider.
- Support multiple clients and their individuals expectations.
- Help Secure establishing patient appointments for the first time visit to the PCP.
- Provide community resources once internal resources have been exhausted (e.g.Financial assistant programs, Medical assistant program resources)
- Work with Network management to ensure panel request are up to date and when providers are not confirming to the contract (e.g.balance billing)
- High School Diploma / GED (or higher)
- 2+ years of experience within the Healthcare Field, Advocacy Service, Customer Service, and / or Call Center Services, Sales, Hospitality
- Ability to create, edit, copy, send and save documents, correspondence, and spreadsheets in Microsoft Word, Microsoft Excel, and Microsoft Outlook
- Ability to work between the hours of 7:00 am - 10:00 pm Monday through Friday
- Associate’s Degree (or higher) and background in the health care industry
- Experience with medical or health terminology
- Bilingual candidates (e.g. English / Spanish)
- Ability to understand and effectively explain complex benefit plans.
- Excellent customer service, interpersonal, communication, and organizational skills.
- Ability to overcome objections and persuade members to take action / change behavior
- Flexibility to customize approach to meet all types of member communication styles and personalities
- Excellent interpersonal, written and verbal communication skills.
- Excellent problem solving and critical thinking skills to resolve complex healthcare issues.
- Strong attention to detail
- Quality focused
- Ability to use multiple systems while assisting consumers
- Excellent conflict management skills including
- Ability to resolve issues under stress
- Diffuse conflict and member distress
- Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer applications and apply their use while on the phone
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.
UHG, Eden Prairie, customer service, healthcare, telephonic, patient interaction, field based, advocacy