Patient Care Navigator & Referral Specialist

UnitedHealth Group; Hillsborough (NC); On-site; USD 25,000 - 44,000; Full time

Job summary

UnitedHealth Group in Hillsborough, NC is seeking a customer service focused team member to support members and clinicians by handling intake, referrals, and care coordination in a fast-paced environment.

The role requires basic office software skills, strong communication, and the ability to navigate multiple screens while assisting callers and providers. A Monday–Friday schedule and hospital-network collaboration are integral to daily duties.

Qualifications

• High School Diploma or GED required.
• At least 1 year of customer service experience.
• Proficient with Microsoft Word and Excel.
• Ability to type while speaking and navigate multiple screens.

Responsibilities

• Manage the intake of members or admission/discharge information post notification.
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers.
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles.
• Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention.
• Handle resolution/inquiries from members and/or providers.
• General office administrative tasks and any other duties.

Skills

Customer service

Multi-tasking

MS Word

MS Excel

Communication

Education

High School Diploma or GED

Tools

Athena

Job description

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, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to startCaring. Connecting. Growing together.

This is variable, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone and supporting our clinical staff face to face and over Teams.

Schedule:Monday - Friday, 8:30am - 5pm EST

Location:NC Center for Resiliency 209 Millstone Drive Hillsborough, NC, 27278

Primary Responsibilities:

• Manage the intake of members or the admission/discharge information post notification
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
• Handle resolution/inquiries from members and/or providers
• General office administrative tasks and any other duties

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
• 1+ years of customer service experience
• Must be able to create, edit, save and send documents utilizing Microsoft Word and Excel
• Must be able to type and talk at the same time and navigate through multiple screens

Preferred Qualifications:

• Experience working within the health care Industry and with health care insurance
• A clerical or administrative support background
• Familiarity with Athena
• Knowledge of ICD-9 and CPT codes
• Experience working with Medicare and/or Medicaid Services
• Call center experience
• Experience working in a metric-driven work environment

Soft Skills:

• Ability to accurately sort and file materials by alphabetic or numeric systems
• Effective communication and customer service skills

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 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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.

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