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, c

Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner Help guide and educate customers about the fundamentals and benefits of consumer driven health care topics such as selecting the best benefit plan options, maximizin

Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner Help guide and educate customers about the fundamentals and benefits of consumer driven health care topics such as selecting the best benefit plan options, maximizin

Responsible for handling inbound calls, from providers and members in a call center environment Conduct initial clinical assessments and determine appropriate levels of care, based on medical necessity Explain and administer benefits according to plan descriptions for all levels of care (OP, IOP,PHP,RTC,IP) Ability to quickly assess and meet time sensitive deadlines withi

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connect

Research issues and develop customers specific solutions Provide in person Member services to both M&R and DSNP members with their languages at retail store, services including but not limited to Benefits Policies, Procedures, and protocols (pre auth, enrollments, renew rewards, etc.) Claim / billing issues (follow up calls with resolution to identified issues in timely m

Program Administration Collaborates with key university departments (Registrar, Bursar, IT Services, University Communications and Marketing, Health Services. Student Life, etc.) to ensure processes pertaining to the SHIP are as smooth and seamless as possible throughout the insurance plan year. Regularly assesses and facilitates the implementation of the annual online st

Respond to client inquiries and concerns ensuring timely service delivery of excellent customer satisfaction Create and assign work orders to multiple technicians, subcontractors, and/or vendors Effectively communicate work order details with technicians, subcontractors, and/or vendors, and effectively provide up to date reports on work order statuses Experience working w

Coach and motivate agents to achieve or exceed sales targets with a focus on quality and compliance Supervise the daily activities of the team by reviewing and analyzing calls / reports, assessing areas of opportunity, managing work assignments and assuring agents are providing a positive consumer experience Develop staff by providing one on one coaching, conducting role

Assist audit management or audit lead in the execution of internal audits including audit planning, detailing control procedures, and the related testing and reporting in accordance with professional and departmental standards including financial (i.e. Sarbanes Oxley testing) and operational projects Prepare clear, accurate and complete workpapers in accordance with depar

Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently Assist members with adverse determinations, including the appeal process Teach members how to navigate UMR internet based wellness tools and resources Outreach to membership providing pre admission counseling to mem

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Com

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Identify potential health care business customers Develop business relationships with agents and/or brokers in order to increase sales Promote sales of health care products to small and medium sized businesses (51 300 employees) customers, through brokers. This includes educating and keeping brokers up to date on products and pricing; evaluating and discussing with broker