Job Description

Description

 

Let's face it, no industry is moving faster than health care. And no organization is better positioned to move health care forward than Optum, part of the UnitedHealth Group family of businesses. We're out to use data, technology and people in ways that help drive change and make the health care system work better for everyone. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 6 industry leader.

Primary Responsibilities:

  • Act as a Subject Matter Expert for other team members
  • Manage the intake of members or the admission/discharge information post notification 
  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services
  • Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
  • Resolve inquiries from members and/or providers


Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a Subject Matter Expert, you'll also be the go-to resource for information. The flexibility to work evening hours will also be required. 

Qualifications

 
Required Qualifications:
  • Active USRN License
  • Experience working within the Healthcare Industry
  • Working knowledge of Medical Terminology to communicate with members and providers
  • Ability to create, edit, save and send documents utilizing Microsoft Word and Excel
  • Ability to navigate a PC to open applications, send emails, and conduct data entry

Preferred Qualifications:
  • Hospital experience in Critical Care areas
  • Professional experience in a clerical or administrative support related role
  • Experience working with Healthcare Insurance
  • Experience working with ICD-9 and CPT codes
  • Experience working with Medicare and/or Medicaid Services

Careers with Optum.  Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do  your life's best work.(sm)

Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity 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.

Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.

Job Keywords: USRN, US Registered Nurse, US Nurse, United States Nurse, United States Registered Nurse, Registered Nurse, RN,  Taguig City, NCR, National Capital Region

Job Field

  Medical & Clinical Operations

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