If you are located within a commutable distance of 3131 Camino Del Rio N, San Diego, CA, 92108, you will have the flexibility to telecommute* (work from home) 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 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.

Due to our ongoing business relationship with the County of San Diego, Optum Behavioral Solutions has an immediate need for a Senior Clinical Administrative Coordinator (CAC). As a Senior CAC, you will provide routine administrative support to the Utilization Management Department, and the CAC sub team. Administrative tasks include intake of authorization requests from providers or managing admission / discharge information post-notification, working with hospitals or other providers and the clinical team. Tasks may include: managing incoming calls, managing requests from providers / members, providing information on available network services and transferring calls as appropriate to clinical staff. The position manages the referral process, prior authorizations, notification to providers, and census review. The Senior CAC would start training in office, with potential to telecommute up to 3 days a week from home, as business needs permit. The clinicians in the Utilization Management department focus on authorizations for psychiatric and chemical dependency patients and the CAC team supports the larger UM team. There are multiple clinical sub teams within UM, that work collaboratively to ensure business needs are met: Inpatient, Crisis and Adult Residential, Outpatient, Long Term Care (LTC), and Substance Use Disorder (SUD).

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 AM - 5:00 PM PST.

Our office is located at 3131 Camino Del Rio N, San Diego, CA, 92108. Employees will be required to work 2 days on - site and 3 days from home.

We offer weeks of paid on-the-job training. Timeframe for training is dependent on candidate's background. The hours of training will be aligned with your normal work schedule.

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

Primary Responsibilities:

• Take initiative to assist other teammates and/or other sub teams within Utilization

• Management (UM) as needed with questions, data entry, guidance, and support and oversee CAC sub team workload, arranging coverage as needed and/or step in to cover as applicable

• Support implementation of any new requirements and current policies, procedures, and processes or assist in updating current processes or creation of new processes

• Assist leadership with projects, running reports, audits and updates as needed

• Attend leadership meetings

• Assist Supervisor with various tasks for business needs and serve as liaison with other departments

• Assist in interviewing, onboarding and training of new hires as requested by Supervisor

• Ensure all work products are covered and contractual and / or regulatory turnaround times met for the sub team and / or the larger Utilization Management team

• Assist with problem resolution as needed

• Participate in Quality Assurance activities as needed and delegated

• Provide feedback to UM Supervisors on opportunities for improvement of the department or operations

• Serve as key point of contact for external stakeholders, providers and County staff as needed

• Model positive, professional, and solution - oriented attitude

• Data entry of authorization requests from providers

• Data entry of client information into several designated databases and County of San

• Diego’s Electronic Heath Record (EHR) System

• Processing high volume inpatient and outpatient authorizations within established turnaround times and serving as back up for other Clinical Administrative Coordinator processes depending on staff availability

• Scan, file, and purge documents

• Efficiently respond to incoming calls and provide prompt and courteous service to customers and guests

• External stakeholders include inpatient hospitals; Residential Substance Use Facilities; Crisis Residential Facilities; Providers; Billers; and County Stakeholders

• Sort through incoming e - faxes, incoming mail for department and incoming faxes through scanner

• Operate a variety of standard office machines, including PC and a variety of computer software, DYMO label, phone, fax, postage calculation, scanner, photocopy machine

• Pursue Common Language of Leadership / developmental goals to enhance skills and performance

• Cross train in other UM sub team processes and provide support as needed

• Support the San Diego Access and Crisis Line as needed

• Process in office paper work products and mail received from providers

• Other duties as assigned by Clinical Managers or Clinical Support Services Supervisor

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 work experience

• 1+ years of customer service experience with analyzing and solving customer problems OR experience in the healthcare industry

• 1+ years of data entry experience in an administrative OR clerical support role

• Ability to create, edit, save, and send utilizing Microsoft Word, Microsoft Excel, Adobe, and other programs

• Ability to type at the speed of 50+ WPM, accurately

• Experience with handling confidential client / patient information

• Ability to navigate a PC to open multiple applications, send emails, and conduct data entry

• Ability to obtain and maintain access to the County of San Diego's electronic health records - Cerner Community Behavioral Health (CCBH) and / OR WITS and / OR Smartcare

• Position requires access to electronic applications and documents which include Individually Identifiable Health Information and Personal Health Information

• Written and verbal communication and customer services skills

• Ability to work autonomously

• Ability to start in office 5 days a week for training purposes and work between the hours of 8:00 AM - 5:00 PM

• Ability to work at least 2 days onsite and up to 3 days from home

• Ability to work any shift between the hours of 8:00 AM - 5:00 PM PST from Monday - Friday

• Must be 18 years of age OR older

Preferred Qualifications:

• 1+ years of Leadership, Subject Matter Expert, OR Team Lead experience

• Presentation skills

• Experience in working with health care insurance

• Experience with working in a hospital, physician's office, OR medical clinic setting

• Working knowledge of Medical Terminology to communicate with members and providers

• Experience in working with ICD - 10 and CPT codes

• Experience in working with Medicare and / OR Medicaid Services

• Experience with working in a call center environment

Telecommuting Requirements:

• Reside within a commutable distance of 3131 Camino Del Rio N, San Diego, CA, 92108

• 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

California Residents Only: The hourly range for this is $19.47 - $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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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