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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Schedule: Monday – Friday, 8:00AM – 5:00PM

Location: 26991 Crown Valley Pkwy, Mission Viejo, CA

Primary Responsibilities:

• Manage and submit daily request for referrals/authorizations

• Maintains on-going and consistent tracking of all referrals/authorizations

• Work with providers and staff to ensure completeness of documentation to facilitate the referral/authorization process

• Assist physicians, as required in coordination of care for patients

• Contact IPA and Health Plans to ensure prior approval requirements are met

• Assemble information concerning patient’s clinical background and referral needs, per referral guidelines and provide appropriate clinical information to specialists

• Ensure referral/authorizations are addressed in a timely manner

• Review details and expectations about referrals with the patients

• Point of contact for patients who raise questions and concerns about referrals/authorizations

• Works collaboratively with Centralized Services to support patient needs

• Establish and maintain relationships with service providers for patient’s coordination of care

• Ensures work is being performed according to company policies, procedures, and standards

• Provides high quality care and service excellence to our patients

• Performs other administrative and clerical duties as assigned

• Participates in a variety of department initiatives

• Ensures all OSHA, HIPAA, and other regulations are followed

• Follows proper reporting protocols for any compliance or incident reporting as needed

• Maintains strict patient and employee confidentiality

• Other duties and responsibilities, not specifically described, maybe defined or assigned from time to time, consistent with knowledge, skills and abilities of the incumbent by management

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• 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.)

• More information can be downloaded at: http://uhg.hr/uhgbenefits

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)

• 1+ years of medical front desk experience

• 1+ years of electronic medical record experience

• 1+ years of health plan insurance knowledge

• Beginner level of proficiency with MS Office (Word, Excel, Outlook, etc.)

Preferred Qualifications:

• Experience with data analysis software

• Bilingual (English / Spanish)

California Residents Only: The hourly range for California residents is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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