** Work Hours: Weekend Sat/Sun 8am-4pm or 4pm- 12am, opportunity for overtime **

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do 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.

Responsible for facilitating out of network admissions and transfers under the direction of the on-call physician. Facilitates hospitalist orders for discharge planning. Ensures that patients who need inpatient care are admitted to right hospital along with our hospitalist. Also responsible for taking after-hours calls from IPA members regarding urgent care facility location and authorization requests. This position directly impact inpatient metric such as admits per thousand, bed days and re-admit rates. Ensures are patients are getting admitted to the correct facility. This is a telecommuting position.

If you are located in La Palma, CA you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Manage administrative intake of members or the admission/discharge information post notification
• Available at all times during on-call hours
• Computer is available on on-line during all on call hours
• Arranges for the facilitation of afterhours discharge orders from acute, SNF facilities and ER such as home health, DME orders and ambulance transfers
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process 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
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
• Ensures the appropriate utilization of capitated and contracted specialists, providers, facilities, and vendors according to region and risk
• Handle resolution/inquiries from members and/or providers
• Identifies and reports need for contracts and/or Letters of agreements. Identifies and communicates high dollar / high risk cases

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. The pace is fast, so your ability to multi-task is essential. You should also enjoy working with people and have the communication skills necessary to build strong relationships with our patients.

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:

• HS Diploma or GED
• 2+ years of customer service experience
• 1+ years of experience as an inpatient UM coordinator
• Experience with MS Word, Excel and Outlook, navigating a PC to open applications, send emails, and conduct data entry
• Experience working within the health care Industry and with health care insurance
• Experience working in a hospital, physician's office or medical clinic setting

Preferred Qualifications:

• Previous inpatient coordination, authorization, discharging patients, manage care
• A clerical or administrative support background
• Knowledge of ICD-9 and CPT codes
• 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
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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

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.