Healthcare Advocate - Groton, United States - UnitedHealth Group

Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Responsible for first-level response and resolution or triage of escalated issues with external and internal customers. Responsible for the overall delivery of benefits and services by providing on-site support and guidance to client. Acts as outward-facing, dedicated resource with direct client contacts for large or complex client issues. Builds relationships with employer and serves as the primary point of contact for day-to- day operational service delivery.

Represents client internally and coordinates with other functions to infuse call / claim service delivery expectations, complete projects, and address ongoing service needs.

Location: 75 Eastern Point Rd Groton, CT 06340

Schedule:
Monday through Friday from 8am-5pm EST


Primary Responsibilities:
Investigate and manage escalated claim/call/appeals issues through root cause analysis and communicate outcome (in person, telephonically or via written communication)

Assist with navigating the healthcare system by providing resources for scheduling appt. and assisting with issues related to prolong periods for scheduling appts

Assist participants with completing health care issues by facilitating interactions with customer service resources, case management and providers

Document and track all issues and activities accurately to includes quantify of people assisted, whether it was in person vs.

virtual, the issue and the resolution.

Simplify and personalize interactions with members and Electric Boat to align with evolving service/quality expectations and single point of contact demands.

(Deliver simply great service)

Track, trend and proactively review accounts for service opportunities

Drive process improvement based on trend analysis

Identify and report system problems in relation with benefit installation and interpretation

Complete ad hoc report requests and analysis

Complete and deliver Performance Guarantee reporting related to calls and claims

Drive excellence in service within organization and across organization by providing feedback to Operations on service failures

Attend Account Management and client meetings representing call and claims

Lead service remediation efforts and a final report back on these efforts

Develop and deliver customer specific (benefit, claim, and cultural) training to internal call and claim teams

Lead process improvement special projects and work teams for dedicated client and potential global impact

Support Open Enrollment (i.e. updating open enrollment database, training call teams, benefit fairs, vendor summits etc.)

Work with Unions as needed related to benefit issues and activities

Occasional travel required

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
High School Diploma/GED or higher

5 + years of customer service experience OR 3+ years of customer management experience

3+ years of experience in healthcare benefits and/or claims

Ability to work in office at 75 Eastern Point Rd Groton, CT 06340 Monday through Friday from 8am-5pm EST

Ability to travel up to 55 miles apart up to 25% of the time

Intermediate level of proficiency with Microsoft Office


Preferred Qualifications:
Experience working with UNET

Experience working onsite with a client

Experience working with unions

Experience working with healthcare providers

Familiarity with manufacturing environments


Soft Skills:
Superior customer service skills

Leadership skills

Strong verbal and written communication skills

Problem - solving skills

Connecticut Residents Only:
The salary range for Connecticut residents is $70,200 to $137,800 per year. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable.

In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

#RPO #Red