Within UnitedHealthcare the seasonality of HEDIS Data Collection in the early part of the year and Small Business sales cycle during the latter part of the year requires additional staff to process peak work volumes.
The Sales Operations Specialist, HEDIS Operations / VO Sales Operations is an innovative UHC role combining two distinct roles requiring employees to flex between positions throughout the year. The employee will report to the HEDIS Operations Department for 5 months and to the Virtual Operations team for 7 months of the year.
Different role and responsibilities apply during each assigned position as outlined below. Different metrics, recognition opportunities and policies / procedures will apply to each role. While in the specific roles, employee will have clear goals and performance expectations as outlined below
- Responsible for the daily support of the sales function to produce quotes and submit sold cases
- Works with business partners such as Underwriting, Rating, and Case Installation
- Works closely with Sales Executive and Brokers to collect information needed to produce a quote or submit a complete sold group
- Responsible for meeting production and quality standards / metrics
- Uses various systems to document the steps of the quote or sold case through completion of customer request
- Conducts claims research, determining correct service location or verifying member history
- Perform provider outreach, verifying and confirming provider demographics and medical record requests, both by telephone and in writing
- Requests medical records and performs follow up of requests within HEDIS database tool
- Maintains HIPAA standards and confidentiality of protected health information
- Will be cross-trained in various functions in order to assist with other functions as directed by HEDIS / VO Supervisor
- High School Diploma / GED (or higher)
- Willingness and ability to telecommute and have a compliant home office environment
- Willingness to accommodate peak and non - peak season schedules
Proficiency within Microsoft Excel (ability to filter and sort through spreadsheets)
- Bachelor's Degree (or higher)
- Experience working with 51+ quotes
- Previous HEDIS experience
- Experience in claims, medical record review, medical billing, or medical office
- Clinical and / or Health Education experience
- Previous experience working with Sales Operations teams in small businesses (1-100 employees)
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.