Job Description

Job Description

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. 

Positions in this function are responsible for providing expertise and customer service support to government and commercial members.

Primary Responsibilities:

• Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as eligibility, benefits, providers and claims
• Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Provide education and status on previously submitted pre-authorizations or pre-determination requests
• Meet the performance goals established for the position in the areas of: service levels, call quality, customer satisfaction and attendance (among others)
• Other duties or project may apply

This role is equally challenging and rewarding. You’ll be spending long periods of time on the phone and called on to research complex issues pertaining to the caller’s health, status and potential plan options. To do this, you’ll need to navigate across multiple databases which require fluency in computer navigation and toggling while confidently and compassionately engaging with the caller.

*** ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***

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:

• 1+ years of customer service experience analyzing and solving customer problems OR 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Ability to work 40 hours / week during standard business operating hours Monday - Friday from 7:00am - 11:00pm. It may be necessary, given the business need, to work occasional overtime, weekends or during high season (October to January). 
• Bilingual Spanish/English proficiency

Preferred Qualifications:

• Call Center experience
• Healthcare experience
• Medical Terminology experience

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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