The role of the Nurse Advocate is to build trusted relationships with members across their health care lifecycle as an RN beginning with benefits concerns and providing treatment education as appropriate. This is done by assisting in Benefit Plan selection and enrollment and educating members about management of their health and well-being and owning administrative customer service inquiries through to resolution.
This role is heavily customer service oriented, time is roughly split to 50% Clinical Support and 50% Administrative Benefits Support and resolution.
Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.
After completing training, you must be available to work one of the below listed shifts and all are in Central Standard Time, Monday through Friday.
Working from home upon completion of training is not a guarantee.
1:35pm - 10:05pm 8x5
12:30pm - 9:00pm 8x5
11:00am - 7:30pm 8x5
10:30am - 7:00pm 8x5
10:00am - 6:30pm 8x5
9:30am - 6:00pm 8x5
9:30am - 8:00pm 4x10
10:30am - 9:00pm 4x10
9:00am - 1:00pm, 7:00pm - 10:00pm Split
8:00am - 12:00pm, 6:00pm - 9:00pm Split
- Assist members with selecting the best benefit plan options available to them through the enrollment process
- Resolve member service inquiries related to:
- Medical benefits, eligibility
- Pharmacy benefits, eligibility
- Correspondence requests & appeals
- Educate members about the fundamentals of consumer-driven health care including:
- Maximizing the value of their health plan benefits
- Choosing a quality care provider
- Premium provider education and steerage
- Treatment decision support and care plan options as appropriate
- Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
- Help members navigate myuhc.com and other UnitedHealth Group websites
- Intervene with care providers on behalf of the member to resolve issues
- Provide process and status on previously submitted pre-authorizations or pre-determination requests
- Educates members in healthcare decision making; to assist in maximizing health care benefits
- Accurately documents member interaction across multiple computer databases in real time, while on the call and appropriately follow all processes and procedures
- Effectively refers and enrolls members to appropriate internal specialists and programs, based on member’s needs and eligibility
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.
- High School Diploma/GED
- Graduate of an Accredited RN Program
- Valid, unrestricted RN License in the state of Georgia
- 1+ year of Service Industry experience working directly with customers/patients
- Proficient in multi-tasking and navigating multiple computer programs simultaneously while talking on the phone
- Training schedule: you must be able to attend an office-based 13 week training class, Monday – Friday, 9:30am-6:00pm EST , starting your first day of employment in the Atlanta office
- Additional state licenses will be required upon beginning the role
- 2+ years of experience as an RN is preferred (Hospital, Clinical, Call Center, Physician’s Office)
- Bachelor's Degree (or higher)
- Call Center experience is strongly desired
- Bilingual fluency with English and Spanish is desired
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: 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.
Call Center Nurse, Nurse Advocate, RN, Registered Nurse, Call Center, Telephonic Nurse, Bilingual, Atlanta, Georgia, GA