Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 14 leader. The Call Center LPN is responsible for assisting members, providers, and clinicians Cared for by Care Services (HouseCalls and Complex Care Management) Advanced Practice Clinicians (APCs). All work is performed in a clinical call center environment. Primary Responsibilities: Resolving concerns for members, providers, and APCs, triaging to the appropriate discipline when necessary (Dietitian, Nurse Care Manager, Pharmacist, Social Worker). Enhance the experience of both internal and external customers by providing excellent customer service. Serve as a bridge between healthcare providers and members to answer questions / address concerns related to member care. Retrieve and respond to voicemail messages, triaging as need. Call members and / or providers with laboratory and / or test results as needed. Access health plan portals to verify benefit eligibility / benefits for patients and seek additional information as necessary Obtains medical records when requested by a provider Perform data entry and complete documentation of calls. Perform data entry into electronic medical record (EMR) utilizing information from an electronic or hardcopy source (referred to as the ISNP Backfilling process) Input / update patient demographic (address, phone number, PVP, PCP, NCM, etc) and healthcare data (medical records, lab / HEDIS results) into EMR and computer database systems. Enter internal referrals to Social Work, Dietitians and Case Managers and locate community resources for members as directed by providers. Uploads Informed Consent, ROI, POA, and other documents as necessary into EMR Enter / process / track patient referral data (e.g., medical services, radiology, durable medical equipment, lab orders, specialist referrals) and follow up until completion. Completes Manual Hospitalization Tracker and other reports per market specifications Generate reports on patient data through relevant computer systems / applications Review / analyze patient data reports (e.g., discharges, hospital admissions / read missions, skilled nursing facilities) and follow up as necessary Draft / provide written communications to patients (e.g., standard letters, welcome letters, educational materials, authorization forms) in compliance with company and health plan guidelines. Process direct referrals from health plan and schedule members for initial visit with provider. Participate in weekly care conference calls with market / weekly market meetings as needed. Manage internal health plan mailboxes / task boxes in the EMR. Ensures PCP communication via auto fax or manual fax of visit notes. Demonstrate understanding of Federal privacy regulations (e.g., HIPPA) and safety guidelines / practices (e.g., OSHA) Ensure that all phone interactions meet quality standards set by the department. Participate in and contribute to staff meetings and other staff development opportunities and interdepartmental work groups. Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies. Other duties as assigned by Supervisor or Manager.
High School Diploma / GED or higher
Current & unrestricted LPN in the State of Maryland
Must be comfortable working Monday - Friday an 8 hour shift between 8am - 8pm
Experience using a computer, keyboard and appropriate software to produce correspondence and function in a computer-based environment using Microsoft Outlook, Word and Excel
Ability to type 30 - 40 WPM
1+ years of clinical experience working in a Physician's office or Hospital setting
2+ years of LPN experience
Managed care experience
Experience in call center customer service
Bilingual with English and Spanish
Bachelor's degree (or higher) in nursing, health education, nutrition, exercise physiology, or closely related field
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.SMDiversity 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.
Keywords: UHG, Columbia, MD, LPN, LVN, field based, nursing, healthcare