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Associate Clinical Review Coordinator - 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.

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, Monday - Friday. Employees are required to work our normal business hours of 9:30am - 6:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.

*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.

    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) -
    • 1+ year of customer service experience analyzing and solving customer problems
    • Experience with Microsoft Word (create, copy, edit, send and save documents) and Microsoft Excel (create, copy, edit, send and save spreadsheets)
    • Ability to work any 8-hour shift between 9:30am - 6:00pm CST


      Preferred Qualifications:


      • Experience working within the healthcare industry and with healthcare insurance
      • A clerical or administrative support background
      • Knowledge of ICD-9 and CPT codes
      • Experience working with Medicare and/or Medicaid Services
      • Call center experience


        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


            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. -

            OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physucuan employees have complete authority with regards to all medical decision-making and patienct care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

            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.

            #RPO #YELLOW

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

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