Patient Care Coordinator

UnitedHealth Group; United States; Remote; USD 25,000 - 44,000; Full time

Benefits offered by this job

Benefits package

401k contributions

Equity stock purchase

Job summary

UnitedHealth Group is seeking a Care Management Support Specialist to coordinate member outreach, conduct transition of care follow-up calls, and assist with the intake and assignment of care management referrals. You will work closely with members, providers, hospitals, and clinical staff to facilitate communication and ensure accurate documentation within care management systems.

This full-time, nationally remote position offers opportunities for collaboration within the Care Management team,

Qualifications

• Minimum high school diploma or equivalent required.
• 2+ years of customer service experience.
• Experience with Windows-based programs (Word, Excel, Outlook, Teams).
• Able to handle lengthy phone interactions with active listening and responsive support.
• Flexibility to work 8-hour shifts Tue–Sat during PST/MST hours and overtime as needed.

Responsibilities

• Perform initial triage of members and intake processing for care management referrals.
• Telephonic outreach to members and follow-up per TOC program.
• Coordinate activities supporting clinical teams via phone, in office, or telecommute setting.
• Liaise with internal/external customers to resolve day-to-day problems.
• Manage care management system tasks and distribute them to teams for timely responses.
• Review/triage inbound referrals and identify medically complex members for referral to staff.
• Support data collection and validation of internal/outbound reports.
• Maintain electronic files, databases, and records as directed.

Skills

Customer service

Communication skills

Windows

Word

Excel

Outlook

Teams

Active listening

Education

High School Diploma / GED

Tools

Windows

Job description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

In this role, the candidate would serve as a key support resource for the Care Management team by coordinating member outreach, conducting transition of care follow-up calls, and assisting with the intake, triage, and assignment of care management referrals. The candidate would work closely with members, providers, hospitals, and clinical staff to facilitate communication, manage inbound and outbound calls, process service requests, and ensure accurate documentation within care management systems. Additionally, the candidate would monitor and distribute work queues, help identify members who may benefit from care management services, maintain records and databases, support reporting and data validation efforts, and participate in team meetings and interdisciplinary care conferences to promote effective care coordination and timely member support.

This position is full time, Tuesday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am - 5:00 pm PST or MWT. It may be necessary, given the business need, to work occasional overtime.

Primary Responsibilities

• Positions in this function include those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing outbound and incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff with ability to enter appropriate information within the clinical documentation system.
• Performs telephonic outreach to members daily and conduct follow-up calls as part of the transitions of care (TOC) program.
• Coordinates and performs a range of activities supporting clinical teams telephonically, in an office, telecommute location or clinical setting.
• Serves as a liaison with both internal and external customers on behalf of the Care Management team in the resolution of day-to-day administrative and operational problems.
• Responsible for managing care management system task pools and distributing tasks to care management teams to ensure a timely response.
• Reviews, triages, and assigns inbound care management referrals from internal and external sources
• Reviews member lists and assists in identification of medically complex members based on eligibility criteria for referral to care management staff.
• Supports data collection validation of internal and outbound reports.
• Electronic file protocol oversite establishes, maintains, and updates files, databases, records, and/or other documents as directed
• Participate in team meetings, multi-disciplinary meetings, care conferences, and other collaboration via appropriate communication methods (teleconference and video conference)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma / GED OR equivalent years of experience
• Must be 18 years of age OR older
• 2+ years of customer service work experience
• Experience with computers including Windows based programs including Microsoft Word, Microsoft Excel, Microsoft Outlook, and Microsoft Teams
• Experience Delivering customer service support through lengthy phone calls, actively listening and responding to customer needs
• Ability to work full time, Tuesday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am - 5:00 pm PST or MWT. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications

• 2+ years of work experience in a medical back office OR medical / healthcare field
• Managed care experience
• Knowledge of medical terminology
• General knowledge of managed care, third party payers, regulatory requirements and government entitlement programs

Telecommuting Requirements

• 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

• Excellent communication skills, particularly telephone skills
• Self-motivated with effective critical thinking skills
• Ability to work collaboratively
• Ability to multi-task and support other areas of the department as needed

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 - $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.