Senior Referral Navigator

UnitedHealth Group•Las Vegas, NV

18h•$20 - $36

About The Position

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. Southwest Medical Referral Office, part of Optum has an immediate opening for a friendly, patient focused and detailed oriented Senior Referral Navigator to join our team. The hours are Monday through Friday are 8:00 am to 5:00pm. No nights or Weekends. Senior Referral Navigator is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals. This is a self-motivated, results driven Provider Management position. This position will require you to be able to self-manage day to day activities to include but not limited to, scheduling weekly and monthly meetings via Teams with providers to go over compliance issues regarding late or missed homecare visits with our members and be capable of using time and resources efficiently. You will need to have a strong phone presence, provide support and manage conflicts while holding the provider accountable in a professional, helpful and friendly manner. You will also be accountable for ensuring all documentation is in place for every step of the process.

Requirements

High School Diploma/GED OR equivalent 5+ years of medical customer service experience
3+ years of experience in a medical setting
Intermediate level of computer proficiency (multi-task through multiple applications including Microsoft Outlook, Excel, and Word)
Valid Driver's license, current automobile insurance with access to reliable transportation that will enable you to travel within a designated area

Nice To Haves

Experience working within the health care Industry and with health care insurance
Experience working in a hospital, physician's office or medical clinic setting
Experience working in a call center
Knowledge of ICD-10 and CPT codes
A clerical or administrative support background
Very fast paced environment with 40+ people, team player, goal focused, must be self - motivated, take initiative and willing to learn in a fast environment
Solid typing, strong oral and written communication skills
Demonstrated effective organizational skills and scheduling skills as observed in day-to-day work
Excellent customer service skills
Excellent interpersonal and problem-solving skills
Attention to detail, as observed in day-to-day work
Excellent time management and prioritization skills.
Must demonstrate flexibility, ability to follow through on all tasks in a timely fashion, good attention to detail and a willingness to learn
Strong team player and team building skills
Able to handle sensitive issues with members and providers in a confidential manner
Demonstrates initiative in achieving individual, team, and organizational goals and objectives
Creative problem-solving skills with the ability to use community and network resources to meet members' needs.
Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment

Responsibilities

Respond to patient questions in person or over the phone
Scheduling patient office/infusion appointments
Processing all outbound referral orders
Obtaining prior authorization for all outbound referrals
Reschedule patient appointments due to cancellation
Back up call center for inbound phone calls
Ask patients for and/or assist patients with completing required paperwork (e.g., health history, insurance documentation, etc.)
Accurately schedules and coordinates patient appointments for assigned clinics
The ability to work in a high call volume environment while meeting productivity and quality standards
Make patient follow up calls (e.g., after procedures, admissions, or ER visits) to identify/close gaps in care
Connect patients with outside resources (e.g., community resources, social services) to promote self-care
Coordinate services/case management for non-episodic and non-catastrophic cases
Manage/respond constructively to challenging patient interactions (e.g., address lack of understanding, socioeconomic challenges, frustrated patients, language barriers)
Document patient interactions in appropriate systems/logs (e.g., medication changes)
Explain and ensure understanding of details related to patient care (e.g., , home health care transition procedures)
Input/update patient demographic data into computer system
Update/upload patient care data (e.g., care plan data, inpatient data, patient program flags) in computer systems
Document patient interactions in appropriate systems/logs (e.g., medication changes)
Enter/process patient referral data (e.g., medical services, radiology, durable medical equipment)
Generate reports on patient data through relevant computer systems/applications
Performs other duties as assigned

Benefits

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability 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 (pet insurance, legal insurance, LTC Insurance, etc.)

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