Senior Referral Navigator

UnitedHealth Group•Las Vegas, NV

15h•$20 - $36•Onsite

About The Position

Optum’s Southwest Medical Referral Office is hiring a patient-focused Senior Referral Navigator to complete established processes and protocols while working cooperatively with care-team members. The role supports the organization’s mission, customer-service standards, Lean processes, and financial, clinical, and service goals. It also includes provider-management work: independently managing daily activities, scheduling weekly and monthly Microsoft Teams meetings with providers to discuss compliance issues involving late or missed homecare visits, using time and resources efficiently, and ensuring each step is documented. The navigator is expected to maintain a strong phone presence and manage conflicts professionally, helpfully, and in a friendly manner while holding providers accountable. The position is located at 2720 Tenaya Drive, Las Vegas, Nevada, and works Monday through Friday, 8:00 a.m. to 5:00 p.m., with no nights or weekends. The role involves patient scheduling and referral processing, authorization coordination, communication with patients and providers, documentation and data entry, and work in a fast-paced, high-call-volume environment.

Requirements

High school diploma/GED or equivalent, with 5 or more years of medical customer-service experience.
At least 3 years of experience in a medical setting.
Intermediate computer proficiency, including the ability to multitask across applications such as Microsoft Outlook, Excel, and Word.
Solid typing skills and strong oral and written communication skills.
Effective organizational and scheduling skills.
Excellent customer-service, interpersonal, and problem-solving skills.
Attention to detail, strong time-management and prioritization skills, and timely follow-through.
Flexibility and ability to assume responsibilities in a constantly changing work environment.
Ability to handle sensitive issues involving members and providers confidentially.
Ability to work as a team player, take initiative, stay self-motivated and goal-focused, and learn in a fast-paced environment.
Ability to use community and network resources creatively to meet members’ needs.

Nice To Haves

Experience in the health-care industry and with health-care insurance.
Experience in a hospital, physician’s office, or medical clinic.
Clerical or administrative support background.
Knowledge of ICD-10 and CPT codes.
Call-center experience.
Strong team-building skills.

Responsibilities

Respond to patient questions in person or by phone.
Schedule patient office and infusion appointments, coordinate appointments for assigned clinics, and reschedule appointments when cancellations occur.
Process outbound referral orders and obtain prior authorization for outbound referrals.
Provide backup support for inbound call-center calls.
Ask patients for required paperwork or help them complete it, including health-history and insurance documentation.
Work in a high-call-volume environment while meeting productivity and quality standards.
Make follow-up calls after procedures, admissions, or emergency-room visits to identify and close gaps in care.
Connect patients with community resources and social services to promote self-care.
Coordinate services and case management for non-episodic and non-catastrophic cases.
Manage challenging patient interactions constructively, including situations involving misunderstanding, socioeconomic challenges, frustration, or language barriers.
Document patient interactions in appropriate systems and logs, including medication changes.
Explain patient-care details, such as home-health transition procedures, and ensure understanding.
Enter and update patient demographic and care data in computer systems, including care-plan data, inpatient data, and patient-program flags.
Enter and process patient referral data for medical services, radiology, and durable medical equipment.
Generate reports on patient data using relevant computer systems and applications.
Self-manage day-to-day activities and use time and resources efficiently.
Schedule weekly and monthly Microsoft Teams meetings with providers to discuss compliance issues related to late or missed homecare visits.
Provide provider support, manage conflicts, and hold providers accountable professionally, helpfully, and courteously.
Ensure documentation is in place for every step of the process.
Perform other duties as assigned.

Benefits

Paid time off accrued beginning with the first pay period.
Eight paid holidays.
Medical plan options and participation in a Health Spending Account or Health Savings Account.
Dental, vision, life and AD&D insurance.
Short-term and long-term disability coverage.
401(k) savings plan.
Employee stock purchase plan.
Education reimbursement.
Employee discounts.
Employee Assistance Program.
Employee referral bonus program.
Voluntary benefits, including pet insurance, legal insurance, and long-term-care insurance.
Performance rewards and incentive and recognition programs.
Equity stock purchase and 401(k) contribution, subject to eligibility requirements.