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Senior Member Outreach Specialist

Company: HCP OptumCare Management, LLC
Location: Pacific Grove
Posted on: May 3, 2021

Job Description:

Excited to grow your career?We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply.Our people make all the difference in our success.Our Welcome Wagon program welcomes new seniors with compassion and respect by ensuring each new senior is positioned for long-term wellness. The Welcome Wagon Member Outreach Representative's primary responsibility is to make outbound calls to new senior members as part of our Welcome Wagon program.Responsibilities: Responsible for outbound calls to all new senior members and scheduling Welcome Wagon visitsResponsible for educating members on how to access their health plan benefitsResponsible for conducting pre-Welcome Wagon visits assessments for our membersResponsible for conducting Welcome Wagon appointment reminder calls the day priorRespond to and resolve on the first call, member service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondenceHelp guide and educate members about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care providerIntervene with care providers (doctor's offices) on behalf of the member to assist with appointment scheduling or connections with internal specialists for assistance when neededAssist members in navigating their payer's network, services, benefits, websites, tools, & apps to encourage and enable members to become self-sufficientOwn problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the memberResearch complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issuesProvide education and status on previously submitted pre-authorizations or pre-determination requestsMeet the performance goals established for the position in the areas of: efficiency, call quality, member satisfaction, first call resolution and attendanceAbility to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as neededRequired Qualifications:1 year of experience with Healthcare Claims, Benefits, &/or Authorizations (i.e. in a doctor's office, HMO, etc.)Able and willing to adjust daily schedule and work over-time and/or weekends, as neededPreferred Qualifications:High school diploma or GED OR 10 years of equivalent working experience1-year experience in call center making outbound callsBilingual in Spanish strongly preferredSoft Skills: Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the memberProficient problem-solving approach to quickly assess current state and formulate recommendationsProficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions members can understand and act uponFlexibility to customize approach to meet all types of member communication styles and personalitiesProficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilienceAbility to proactively identify member needs and meet themCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. 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. Here you'll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Referral Bonus:Job Location Address:19191 South Vermont Ave., Torrance, 90502

Keywords: HCP OptumCare Management, LLC, Salinas , Senior Member Outreach Specialist, Other , Pacific Grove, California

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