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UnitedHealth Group Care Navigator WellMed Healthcare San Antonio TX in Seguin, Texas

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health. WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.

Multiple Care Navigator openings due to growth in membership. Will be working with Nurses 1 on 1 to provide end to end care.

Primary Responsibilities:

  • Manage administrative intake of members

  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers

  • Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles

  • Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

  • Handle resolution/inquiries from members and/or providers

This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.

Required Qualifications:

  • HS Diploma or GED

  • 2+ years of customer service experience

  • Experience with MS Word, Excel and Outlook

Preferred Qualifications:

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

  • Experience working in a hospital, physician's office or medical clinic setting

  • A clerical or administrative support background

  • Knowledge of ICD-9 and CPT codes

  • Experience working in a call center

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 350,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: WellMed,Healthcare, Bilingual, Customer Service, Clinical Admin, Patient Care Coordinator, Hospital, Physician's Office, Clinic, San Antonio, Managed Care, Case Management, Call Center, Referrals, Prior Authorizations, Intake, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, 78249, Texas, TX

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