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 start Caring. Connecting. Growing together.

This position is full-time (40 hours/week) Monday- Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 8:00am-5:00pm EST. It may be necessary to commute to provider offices within the New Bern, NC area about 35% of the time. This amount of travel is subject to change based on COVID-19 events and regulation. Our office is located at Greenville NC 835 JOHNS HOPKINS Dr Greenville NC 27834

We offer 4-8 weeks of paid training. The hours during training will be 8:00 am to 5:00 pm EST, Monday - Friday.

Primary Responsibilities:

• Assist in the review of medical records to highlight Star opportunities for the medical staff

• Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities

• Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data

• Track appointments and document information completely and accurately in all currently supported systems in a timely manner

• Optimize customer satisfaction, positively impact the closing of gaps in care and productivity

• Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed

• Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities

• Answer inbound calls from members and/or providers regarding appointments

• Communicate scheduling challenges or trends that may negatively impact quality outcomes

• Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs

• Provide ongoing support and education to team members and assist in removing barriers in care

• Manage time effectively to ensure productivity goals are met

• Ability to work independently in virtual setting. Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise

• Identify and seek out opportunities within one’s own work flow to improve call efficiency

• Adhere to corporate requirements related to industry regulations/responsibilities

• Maintain confidentiality and adhere to HIPAA requirements

• Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level

• Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events

• Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts

• Field based activities require the abilities to support appropriate targeted providers

• Other duties, as assigned

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

• 18 years or older

• 2+ years of telephonic customer service experience

• 1+ years of healthcare background with medical terminology and clinical issues familiarity

• 1+ years of working experience with ICD- 9/10 and CPT Codes

• 1+ years of working experience with knowledge of HIPAA compliance requirements

• 1+ years of working experience with Microsoft Tools: Microsoft Word (create and edit correspondence) and Microsoft Outlook (email and calendar management)

• Experience with navigating, filtering and analyzing reports in Microsoft Excel

• Ability to travel up to 75% of the time within the Greenville, NC area.

• Reside within commutable distance of Greenville, NC

• 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

• Ability to work any of our our 8 hour shift schedules during our normal business hours of 8:00am-5:00pm EST. Monday to Friday

Preferred Qualifications:

• 1+ year experience as a pharmacy techs

• Experience working in a physician, provider, and/or medical office is preferred.

• Medical Assistant

• LPN

• EMR and HEDIS knowledge and experience

• Pharmacy tech license

Soft Skills:

• Strong data entry skills, with a typing speed of at least 45-50 WPM

• Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities

• Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect

• Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve goal(s)

• Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer

• Good Attendance Record

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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