Optum
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
Our Care Navigators have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care. Care Navigators will carry a case load and will work with clinical staff. Coordinate care with providers, schedule appts, arrange transportation, make sure members are aware of all their benefits, check for upcoming appts and schedule & identify gaps for members. Mostly outbound calling but blended with a few incoming callings using auto dialer and manual dialing. This position is full time Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9am – 5:30pm EST. It may be necessary, given the business need, to work occasional overtime. We offer 3 weeks of on-the-job training. The hours during training will be 9:00 am to 5:30 pm local time. If you are located within the State of North Carolina, you will have the flexibility to work remotely* as you take on some tough challenges.
Required Qualifications: High School Diploma / GED Must be 18 years of age or older 1+ years of call center and / or telephonic customer service experience 1+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties 1+ years of Healthcare/ insurance experience and/or Social work/community outreach/advocacy experience 1+ years of experience analyzing and solving customer problems Work experience using Microsoft Word (edit, create & save documents), Microsoft Excel (sorting & filtering data), and Microsoft Outlook (email, folders, attachments and calendaring) Ability to work Monday – Friday 9:00am-5:30pm EST Preferred Qualifications: Social Work, Public Health or related field Bilingual fluency in English and Spanish OR other language Medicaid and / or Medicare experience Experience working with medical terminology Telecommuting Requirements: Reside within the state of North Carolina 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: Must be able and comfortable with maintaining metrics and goals within the department Must be comfortable working on the phone and multiple systems on the computer simultaneously while assisting members Must be comfortable making outreach to members without prior engagement Excellent Organizational Skills Telephone etiquette
Completes telephonic outreach to DSNP/CSNP members utilizing multiple outreach modes: including auto-dialer, manual and inbound calls Educates member on gaps in care and assists with closure of gaps, including scheduling provider appointments Assists members with social determinants of health and links to community resources Ensures member has access to PCP Outreaches members on caseload consistent with program guidelines Consistently meets metrics, both quality & performance Provides excellent customer service to both members and providers Constantly maintains schedule adherence and good attendance Maintains confidential health information according to state and federal regulations including HIPAA.
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