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Associate Clinical Administrator - National Remote

Company: UnitedHealth Group
Location: Boston
Posted on: November 26, 2022

Job Description:

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work. SM

Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.

This position is full-time, Thursday - Sunday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00am - 7:30pm Central Standard Time. It may be necessary, given the business need, to work occasional overtime.

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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
    This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.

    Positions in this function includes 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 incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
    • Limited work experience
    • Works on simple tasks using established procedures
    • Depends on others for guidance
    • Work is typically reviewed by others
      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 higher) OR equivalent experience
      • 1+ years of customer service experience analyzing and solving customer problems
      • Able to create, edit, save and send documents utilizing Microsoft Word and Excel
      • Ability to work from Thursday - Sunday 9:00am - 7:30pm Central Standard Time
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
        Preferred Qualifications:
        • 1+ years of Call center experience
        • Experience working within the health care Industry and with health care insurance
        • A clerical or administrative support background
        • Experience working with Medicare and/or Medicaid Services
          Telecommuting Requirements:
          • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
          • Ability to keep all company sensitive documents secure (if applicable)
          • 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 to type and talk at the same time and navigate through multiple screens
            • Experience working in a metric-driven work environment
              UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

              Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

              Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

              Ready to answer the call? Take this opportunity to do your life's best work.

              UnitedHealth Group is working to create the health care system of tomorrow.

              Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

              Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

              Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

              Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

              Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $16.00 - $23.51. The salary range for Connecticut / Nevada / New York City residents is $16.00 - $25.77. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

              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.

Keywords: UnitedHealth Group, Boston , Associate Clinical Administrator - National Remote, Healthcare , Boston, Massachusetts

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