Telephonic Care Navigator

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the healthcare system and connect them to key support services. This preventive care can help patients stay well at home. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

Our Telephonic Care Navigators have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care. Care Navigators will carry a case load and work with clinical staff, coordinating care with providers, scheduling appointments, arranging transportation, ensuring members are aware of their benefits, checking for upcoming appointments, and scheduling & identifying gaps for members. Mostly outbound calling but blended with a few incoming calls using auto dialer and manual dialing.

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 9:00 AM - 5:30 PM EST. It may be necessary, given the business need, to work occasional overtime.

We offer 3 weeks of paid on-the-job training. The hours during training will be 9:00 AM - 5:30 PM local time.

If you are located within the state of North Carolina, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Completes telephonic outreach to DSNP / CSNP members utilizing multiple outreach modes: including auto-dialer, manual, and inbound calls
• Educates members on gaps in care and assists with closure of gaps, including scheduling provider appointments
• Assists members with social determinants of health and links to community resources
• Ensures member has access to PCP
• Outreaches members on caseload consistent with program guidelines
• Consistently meets metrics, both quality & performance
• Provides excellent customer service to both members and providers
• Constantly maintains schedule adherence and good attendance
• Maintains confidential health information according to state and federal regulations including HIPAA

Required Qualifications:

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of call center and / OR telephonic customer service experience
• 1+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties
• 1+ years of Healthcare / insurance experience and / OR Social work / community outreach / advocacy experience
• 1+ years of experience with analyzing and solving customer problems
• Work experience with using Microsoft Word, Excel, and Outlook
• Ability to work any of our full-time, 8-hour shift schedules during our normal business hours of 9:00 AM - 5:30 PM EST from Monday - Friday

Preferred Qualifications:

• Social Work, Public Health, OR related field
• Medicaid and / OR Medicare experience
• Experience in working with medical terminology
• Bilingual fluency in English and Spanish OR any other language

Telecommuting Requirements:

• Reside within the state of North Carolina
• Ability to keep all company sensitive documents secure
• Required to have a dedicated work area separated from other living areas providing information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection.
• Capability to work from home (access to high-speed broadband)
• Previous experience as a telecommuter

Soft Skills:

• Must be able to maintain metrics and goals within the department
• Comfortable working on the phone and multiple systems on the computer simultaneously while assisting members
• Comfortable making outreach to members without prior engagement
• Excellent Organizational Skills
• Telephone etiquette

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.