Complex Customer Care Representative Senior

UnitedHealth Group•Las Vegas, NV

5d•$20 - $36•Onsite

About The Position

This position is Onsite. Our office is located at 2720 N Tenaya Way, Las Vegas, NV 89128. 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. Patient Experience Department supports creating a complete and positive service experience from enrollment, through all touch points within system as well as any escalated service recovery. Complex Customer Service Representative Senior will function as a support department for the Mountain West and local care delivery system in the following areas; patient service resolution, complaint management, patient feedback, and Burke survey data distribution. Complex Customer Service Representative Senior will support patient experience improvement efforts that align with company’s consumer experience initiatives. All members of the Patient Experience team will maintain professional, helpful behavior and language according to company policies and procedures.

Requirements

High School Diploma / GED
Must be 18 years of age OR older
3+ years of experience in healthcare, customer service or patient experience-related field
Experience with Computers and Windows based programs
Ability to work on-site. Our office is located at 2720 N Tenaya Way, Las Vegas, NV 89128
Available to work during our normal business hours of 8:00am - 5:00pm PST, Monday - Friday. It may be necessary, given the business need, to work occasionally overtime or weekends

Nice To Haves

Experience handling escalated calls
Excellent written and verbal communication skills

Responsibilities

Collaboration with all OptumCare Mountain West departments and IPA offices to ensure the best possible patient experience.
Focuses on proactive: best practices, consultation and improvement, and other assigned initiatives/projects and reactive job duties: complaint management and resolution.
Manages all patient issues and concerns via dedicated service resolution line (702) 242-HELP line with a compassionate and helpful demeanor delivering White Glove service to all stakeholders.
Assist will receive all messages via the Patient Experience inbox, providing assistance for employees and departments, including but not limited to; UHC Sales Team, member services, scheduling, clinic management.
Serves as a liaison between customers, patients and / or their families and SMA / OptumCare Mountain West region (i.e., sales, support, clinical departments, and administration) and provides insight and information as it relates to both improvement and complaint management processes.
Provide compassionate patient centric escalated service recovery and complaint resolution for all OptumCare – Mountain West patients.
Creates reports and share metrics, which may include complaint, patient satisfaction, CAHPS/HOS and other quantitative and qualitative data.
Facilitates patient and / or family meetings and helps managers and providers navigate the complaint management process seeking service resolution and patient satisfaction.
Investigates and documents the patient's concerns in a timely manner, and works with clinical and support staff to coordinate a prompt response to the patient and stakeholders.
Assist all the patient issues identified by patient outreach, surveys, and or transfers to senior population within the Nevada, Arizona, and Utah market. Assist patients that may be contacted once per calendar year prior/concurrent to the CAHPS/HOS surveying period.
Accurately track and document all patient issues in Salesforce, report and identify reoccurring service issues and assist with root cause analysis and data in creating strategic planning.
Multi-departmental collaboration with Risk Management, Consumer Affairs, Office of Compliance and Legal Department to resolve issues that may involve Risk to the organization.
Compiles, analyzes and interprets findings/trends for further review by institutional leadership in order to forecast process and service improvement initiatives.
Must function objectively in sensitive and stressful situation, while maintaining a helpful, collaborative, and positive attitude.
Must be self-motivated and accountable for meeting expected deadlines and service level agreements, for all reporting tools and our 242-HELP line.
Must work autonomously, "think on one's feet", anticipate patient needs, improvise, and synthesize extensive information to focus and resolve the issue meeting our service level agreements.
Responsible for developing and managing cooperative and respectful business relationships that will enhance services available to patients and guests including current physicians, clinic and hospital staff relationships to ensure an optimal patient experience.
Responsible for contributing to the creation of and editing of C-I-CARE training material and supporting documentation.
Expected to role model the OptumCare C-I-CARE service standards with all colleagues, patients and staff of other departments as a positive representation of the patient Experience Department.
Assist with special projects and/or activities as requested by SVP and VP of Patient Experience or other leadership staff.
Other duties as assigned.