The quality of care we provide our patients doesn't change no matter how it is delivered. Joining UnitedHealthcare as a Call Center Registered Nurse can be your opportunity to offer a higher level of care to our members. While your work will take place over the phone, you'll have a direct impact on the lives of our members, recommending an appropriate level of clinical care and connecting them with the resources they need to make informed health decisions. You'll act as a compass for our members, guiding them through a complex medical environment as you identify appropriate providers and services, act as a health coach and provide referrals in order to optimize health outcomes. This is an exciting time to join a truly inspired organization. Take this opportunity and begin doing your life's best work.(sm) The role of the Nurse Advocate is to build trusted relationships with members across their health care lifecycle as an RN (with current licensure), beginning with benefits and claims concerns and providing treatment education as appropriate. This is done by assisting in Benefit Plan selection and enrollment, explaining claims processing, and educating members about management of their health and well-being, and owning administrative customer service inquiries through to resolution. This role is heavily customer service oriented, time is roughly split to 30% Clinical Support and 70% Administrative Benefits and Claims Support and resolution. Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.**This is an office-based role for the first year, after 12 months if you are meeting performance metrics you may be able to transition to a telecommuter, however there is no guarantee.**Primary Responsibilities: Provides white-glove level service, removing burdens and providing end-to-end resolution for members. This includes, but is not limited to: Clinical, Financial Decision Support, Behavioral Support, Claims inquiries, and moreAnswer up to 50 to 70 incoming calls per day from members of our health / dental / vision / pharmacy plansResolves escalated complex and repeat calls from members and works directly with business partners (complex claim reconsiderations, notifications, appeal considerations)Monitor and provide proactive support to members with more chronic disease process issuesWork with partners including medical, clinical, financial, behavioral and Rx to resolve issuesProvide coaching as neededProvide feedback on process improvementWork with supervisors on enhancing performance
Required Qualifications: Graduate of an Accredited RN Program Valid, unrestricted RN License Proficient in multi-tasking and navigating multiple computer programs simultaneously while talking on the phone Training schedule: you must be able to attend 16 week training class (training hours are 8:00am-4:30pm Monday –Friday), starting your first day of employment Additional state licenses will be required upon beginning the role After completing training, you must be available to work a shift between the hours of 7am -10pm Central Standard Time, Monday through FridayPreferred Qualifications: 2+ years of experience as an RN (Hospital, Clinical, Call Center, Physician's Office) Bachelor's Degree (or higher) Call Center experience Bilingual fluency with English and Spanish Work from home is not a guaranteeCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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) 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. Job Keywords: Call Center Nurse, Nurse Advocate, RN, Registered Nurse, Call Center, Eden Prairie, MN, Minnesota
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.