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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Employees in this position will work as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of UHC Medical & Retirement membership.
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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 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.
We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.
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