If you are in San Diego, CA, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

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.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

Our office is located at 3900 FIFTH AVE Suite 370 San Diego CA 92103. Employees will be required to work some days onsite and some days from home.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Mange 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 from members and/or providers

• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles

• Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention

• Handle resolution/inquiries from members and/or providers

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 equivalent work experience

• Must be 18+ years or older

• 1+ years of customer service experience analyzing and solving customer problems

• Proficiency with Microsoft Word and Excel (ability to create, edit, save and send documents and spreadsheets)

• Ability to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

Preferred Qualifications:

• Call center experience

• Clerical or administrative support background

• Knowledge of ICD-10 and CPT/HCPCS codes

• Experience working in a metric-driven work environment

• Experience working with Medicare and/or Medicaid Services

• Experience working within the health care Industry and with health care insurance

Telecommuting Requirements:

• Reside within commutable distance of 3900 FIFTH AVE Suite 370 San Diego, CA 92103

• Ability to keep all company sensitive documents secure (if applicable)

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills:

• Must be able to type and talk at the same time and navigate through multiple screens

California Residents Only: The hourly range for California residents is $16.00 - $28.27 per hour. 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 .

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