Senior Complex Customer Care Representative

UnitedHealth Group•Minneapolis, MN

1d•$20 - $36•Remote

About The Position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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. The Wellbeing Specialist is part of a team focused on behavioral health and emotional wellbeing navigation and support. The team is responsible for initial triage, benefit education, member navigation guidance, and counseling. The primary responsibility for a Wellbeing Specialist is to provide one-to-one engagement support with the member, listening for spoken and unspoken needs and then guiding members to the most appropriate resources available. Wellbeing specialists will engage members in Case Management including assessment, care plan development, and intervention follow up. The team is empowered to achieve the best possible outcome for the consumer by understanding where the member is at with their needs and ensuring the member receives the right care at the right time. The role includes telephonic, digital chat, and/or digital messaging for member engagement. Work volume comes from both an inbound and outbound queue, both on demand and self-managed. Wellbeing Specialists are trained on the foundations of coaching and expected to fulfill their job duties by applying this skillset as a means of experience design. Wellbeing Specialists are expected to support goal articulation and activate the appropriate benefit or resource available to each unique member. This includes various clinical resources within the team and through broad partnerships in the organization. This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8.5-hour shift schedules during our normal business hours of 6:45am – 10:15pm CST. It may be necessary, given the business need, to work occasional overtime. We offer 10 weeks of paid training. The hours during training will be 9:00am to 5:30pm CST, Monday - Friday. Training will be conducted virtually from your home.

Requirements

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
Written, verbal, and interpersonal skills
Qualified staff must be able to use various computer applications and navigate through multiple computer screens while engaging with members
1+ years of customer service or call center
Customer service role in healthcare or insurance provider
Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8.5-hour shift schedules during our normal business hours of 6:45am – 10:15pm CST. It may be necessary, given the business need, to work occasional overtime.

Nice To Haves

Social work OR mental health background
1+ years of claims experience
Knowledge of payer and provider billing and claims in a healthcare setting
3+ years of experience in clinical or health insurance setting

Responsibilities

Provided training in coaching skills foundations and successfully employs techniques in engagements with a focus on member goal articulation and achievement.
Fosters a service-oriented environment and participates in human centered experience development.
Genuine passion for improving a member’s behavioral health experience
Anticipates member needs and proactively identifies solutions.
Provides services for adults, youth and families via inbound and outbound phone queues, inbound chats, and additional communications
Assesses and interprets member needs, including listening for risk cues and calmly assessing for risk and transferring to clinical team.
Identifies solutions to non-standard requests and problems.
Solves complex problems on own; proactively identifies new solutions to problems.
Applies knowledge/skills to complex activities.
Plans, prioritizes, organizes, and completes work to meet established objectives.
Translates concepts in practice.
Provides explanations and information to others on difficult issues.
Acts as a resource for others with less experience.