Optum Healthcare Advisor - Atlanta, GA

UHG Atlanta, GA

About the Job

Our Optum Health Care Advisor role is challenging, rewarding, and allows for individual growth and the chance to focus on a variety of skills.  Are you ready to make heath care work better?


An Optum Health Care Advisor (OHCA) is a single point of contact for consumers for all things related to  health and wellness benefits. A Health Care Advisor helps members navigate the health care system; including helping with claim and benefits questions, helping members find quality doctors and schedule appointments; connecting consumers with health and wellness resources; and coaching members to make better health choices by providing education. A Health Care Advisor creates an ongoing and lasting impression of the Optum consumer experience.


This position is full-time (40 hours/week) Monday- Saturday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (6:50am - 10:00pm Monday-Friday and 8:00am-4:30pm Saturday). It may be necessary, given the business need, to work occasional overtime. Our office is located at 11000 Optum Circle, Eden Prairie, MN 55344.


There are several steps in our hiring process. Please make sure that you have filled out all required sections of your employment application. Once you submit your completed application, you will receive an email with information regarding next steps including any pre-employment assessment(s) that are required.  Both your application and any required assessment(s) need to be completed before we can consider you for employment so the sooner you complete these two steps, the sooner you will hear from us. To learn more, go to: http://uhg.hr/OurApplicationProcess


Primary Responsibilities:

  • Handle inbound and outbound calls with an emphasis on excellent customer service in a call center environment.
  • Take responsibility for addressing member issues, questions, concerns, and see them through to resolution.
  • Respond to members and providers in a polite and courteous manner, with patience, empathy, care, compassion, and sincerity in voice tone and pace.
  • Assist members with medical and pharmacy benefits, medical plan overview, behavioral health inquiries, claims, provider search and prior authorization.
  • Provide member education on HSA, FSA, HRA, and other financial accounts.  
  • Serve as a Health Care Advisor, going above and beyond for consumers, creating a memorable consumer experience, and providing expert, proactive service to members by:
    • Finding creative ways to do more than what the member expects
    • Delighting each member by meeting their unexpressed needs
    • Leaving each person feeling confident and cared for 
  •  Provide services such as:
    • Education to help simplify the healthcare system and validate members understanding of  next best actions
    • Advise members in choosing healthcare providers that meet and exceed consumer needs
    • Educate members on clinical and wellness resources they can take advantage of to manage a health condition/disease or reach a wellness goal
    • Provide education to members to assist in understanding benefits, terminology, claim resolution and Explanation of Benefit interpretation
    • Serve as an advocate by responding to, resolving and escalating complex claim issues with internal and external resources
    • Initiate telephone calls to internal sources, membership, providers, and other claim payers to gather data and determine resolution to claim issues
    • Refer qualified members into Wellness and clinical programs
    • Solve problems systematically, using sound business judgment, and following through on commitments 
  • Consistently meet established productivity, schedule adherence, meeting metric expectations, and quality audit standards
  • Work with cross carries to ensure member follow up and resolution (cross carrier functions)
  • Work with providers and plans to help ensure critical info is being relayed timely between the plan and the provider.
  • Support multiple clients and their individual expectations.
  • Help establish patient appointments for the first time visit to the PCP.
  • Provide community resources once internal resources have been exhausted (e.g. Financial assistant programs, Medical assistant program resources)
  • Work with Network management to ensure panel request are up to date and when providers are not confirming to the contract (e.g.balance billing)

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:

  • High School Diploma / GED or higher 
  • 1+ years of experience within the Healthcare Field, Advocacy Service, Customer Service, and/or Call Center Services, Sales, Hospitality.
  • Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer applications and apply their use while on the phone
  • Proficiency (edit/save/create/send) with Microsoft Office (Excel, Word, Outlook, and PowerPoint)

Preferred Qualifications:

  • Associate’s Degree or higher in related field
  • Experience with medical or health terminology
  • Multi-lingual candidates (e.g. English/Spanish)

Soft Skills:

  • Ability to excel in a fast-paced work environment where constant learning, change, and multi-tasking is required
  • Ability to organize and prioritize tasks efficiently
  • Ability to understand and effectively explain complex benefit plans.
  • Excellent customer service, interpersonal, communication, and organizational skills.
  • Ability to overcome objections and persuade members to take action / change behavior
  • Flexibility to customize approach to meet all types of member communication styles and personalities
  • Excellent interpersonal, written and verbal communication skills.
  • Excellent problem solving and critical thinking skills to resolve complex healthcare issues.
  • Strong attention to detail
  • Quality focused
  • Ability to use multiple systems while assisting consumers
  • Excellent conflict management skills including
    • Ability to resolve issues under stress
    • Diffuse conflict and member distress

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

 

Some of the steps we’ve taken to ensure employee well-being include:

  • Launched our ProtectWell app and UnitedCARES program to help ease the burden and stress for our UnitedHealth Group team members and their immediate family affected by COVID-19

  • Daily updates from our CEO Dave Wichmann to support and inspire team members during this challenging time

  • Onsite social distancing and increased sanitization measures for employees who have been welcomed back to our offices

  • Fully cover the COVID-19 healthcare costs for our employees

  • Employees who self-identify as high risk or who live with someone who is high risk have been asked to remain working from home

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html


Careers 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.


Keywords: UnitedHealth Group, UnitedHealthcare, Optum, training class, customer service representative, customer service, CSR, inbound calls, Call Center, OHCA, Health care advisor, Benefits, claims. hiring immediately