Member Outreach Specialist - Telecommute In St. Louis, MO

Unitedhealth Group Inc. Saint Louis , MO 63150

Posted 2 weeks ago

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.SM

Employees in this position will work on - site or virtually as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and / or physician practices that manage a high volume of UHC Medicare & Retirement membership.

Primary Responsibilities:

  • Assist in the review of medical records to highlight Star opportunities for the medical staff

  • Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities

  • Locate medical screening results / documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data

  • Track appointments and document information completely and accurately in all currently supported systems in a timely manner

  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity

  • Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members

  • Interaction with UHC members via telephone to assist and support an appropriate level of care

  • This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities

  • Answer inbound calls from patients and / or providers regarding appointments

  • Communicate scheduling challenges or trends that may negatively impact quality outcomes

  • Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs.

  • Provide ongoing support and education to team members and assist in removing barriers in care

  • Manage time effectively to ensure productivity goals are met

  • Ability to work independently in virtual setting

  • Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise

  • Identify and seek out opportunities within one's own work flow to improve call efficiency

  • Adhere to corporate requirements related to industry regulations / responsibilities

  • Maintain confidentiality and adhere to HIPAA requirements

  • Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level

  • Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events

  • Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts

  • Field based activities require the abilities to support appropriate targeted providers

  • Concentrate on outreach to hard to reach / hard to contact UHC members of any assigned population based on need, and priority as assigned

  • Out read via telephonic inquiries using a UHC member list and initiates steps to assist members regarding issues relating to quality and appropriate levels of care. This may include making outbound calls to members and / or providers to assist in scheduling appointments, closing gaps in care or chart collection activities

  • Other duties, as assigned

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 2 years of telephonic customer service experience

  • 1 year of a healthcare background with medical terminology familiarity of clinical issues

  • 1 year of working experience with Microsoft Tools: Word (creating memos, writing), Outlook (setting calendar appointments, email) and Excel (creating spreadsheets, filtering, navigating reports)

  • 1 year of working experience with and knowledge of HIPAA compliance requirements

  • Ability to work Monday Friday, 8am - 5pm

  • Ability to travel up to 25% of the time throughout St. Louis and surrounding areas

Preferred Qualifications:

  • 1 year of working experience with ICD - 9 / 10 and CPT Codes

  • Experience working in a physician, provider, and / or medical office is preferred

  • Previous experience working as a Medical Assistant or LPN

  • Knowledge and experience with EMR and HEDIS

  • Strong data entry skills, with a typing speed of at least 45 - 50 WPM

Soft Skills:

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities

  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect

  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)

  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer

  • Good Attendance Record

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.SM

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Optum, St. Louis, MO, performance, clinical, community, health, worker, telecommute

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Member Outreach Specialist - Telecommute In St. Louis, MO

Unitedhealth Group Inc.