This position follows a hybrid schedule with three (3) in-office days per week. Our office is located at 31 Beaver Street, Cooperstown, NY 13326.
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.
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:
Coordinate and supervise daily/weekly/monthly activities of a team members
Set priorities for the team to ensure task completion and performance goals are met
Coordinate work activities with other supervisors, managers, departments, etc.
Identify and resolve operational problems using defined processes, expertise and judgment
Provide coaching, feedback and annual performance reviews as well as formal corrective action
Demonstrate understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
Ask appropriate questions and listen actively to identify underlying questions/issues (e.g., root cause analysis)
Gather appropriate data/information and perform initial investigation to determine scope and depth of question/issue
Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed
Proactively contact external resources as needed to address caller questions/issues (e.g., providers, labs, brokers)
Utilize appropriate knowledge resources to drive resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
Identify and communicate steps/solutions to caller questions/issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
Offer additional options to provide solutions/positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)
Make outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, pharmacies)
Drive resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
Ensure proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution)
PHO Develop and Maintain Productive Relationships/Interactions with Callers
Manage caller conversations appropriately (e.g., provide a good first impression, command attention and respect, maintain professional tone, demonstrate confidence, de-escalate/defuse callers as needed)
Apply knowledge of applicable Service Level Agreements (SLAs) and Performance Guarantees when interacting with callers
Maintain ongoing communications with callers during the resolution process to communicate status updates and other required information
Maintain focus on caller interactions without being distracted by other factors (e.g., system usage, pop-up alerts, VCC data)
Acknowledge and demonstrate empathy/sympathy with callers' life events (e.g., wedding, birth of baby, loss of relative, recent illness)
PHO Demonstrate Business/Industry Knowledge
Demonstrate knowledge of applicable health care terminology (e.g., medical, dental, behavioral, vision)
Demonstrate knowledge of applicable products/services (e.g., benefit plans, disability, COBRA, FSA, HRA)
Obtain and apply knowledge of benefit structures/designs for contracted or acquired companies
Ensure compliance with applicable legal/regulatory requirements (e.g., HIPAA, state/regional requirements)
Maintain knowledge of information/process changes due to healthcare reform, referring to applicable company resources (e.g., dependent age, removal of lifetime limits, free preventive care services, Medical Loss Ratio)
Demonstrate knowledge of established workflows and support processes (e.g., available resources, internal/external business partners, points of contact)
Demonstrate knowledge of relevant internal processes impacting caller issues (e.g., claims processing, auto-adjudication)
Identify inaccurate/inconsistent information found in systems/tools, and communicate to appropriate resources (e.g., IBAAG, SOP, AYS, SPDs, policies/procedures)
PHO Provide Consulting/Education on Caller Issues/Trends
Communicate common problems/questions presented by callers to appropriate Subjects Matter Experts, to drive continuous improvement
Educate callers on available products/services (e.g., features, functionality, options, additional offerings, preventive services, agerelated services)
Educate callers on self service resources available to them, and on their responsibilities with regard to their health care coverage
Refer callers to other resources applicable to their questions/issues, where appropriate (e.g., pharmacists, prior authorizations, billing department)
Review/analyze phone support data/metrics and communicate patterns/trends to internal stakeholders, as needed (e.g., leadership, Subject Matter Experts, business partners)
Provide training/mentoring to other team members, as needed (e.g., new-hires, refresher training)
Participate in customer site visits, as needed (e.g., to obtain feedback, provide education, clarify support processes, highlight
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 equivalent work experience
Must be 18 years of age OR older
3+ years of healthcare customer service
Proficiency with Windows PC applications
Reside within commutable distance of Cooperstown, NY
Ability to work three days per week onsite at 31 Beaver Street, Cooperstown, NY 13326.
Ability to work 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 and on-call availability may also be necessary.
Preferred Qualifications:
Knowledge of call center systems such as AMTELCO, CMS, IEX, CTI and TCS
Understanding of call center performance metrics and measurements
1+ years of supervisory/leadership experience
Telecommuting Requirements:
Reside within commutable distance to the office at 31 Beaver Street, Cooperstown, NY 13326.
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 - $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RPO
