Explore opportunities with Optum, in strategic partnership with ProHealth Care. ProHealth Care is proud to be a leader in health care services, serving Waukesha County and the surrounding areas for more than a century. Explore opportunities across the full spectrum of care as you help us improve the well-being of the community with your skills, compassion and innovation. Be part of a collaborative environment that strives for excellence, nurtures respect and ensures high-quality care delivery to our patients. Join us in making an impact as an Optum Team Member supporting Pro Health Care and discover the meaning behind Caring. Connecting. Growing together. 

Primary Responsibilities:

• Working with a team of nurses to obtain CMS required forms

• 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

• Assist the clinical staff in denials management and utilization management: faxing, scanning and portal entries

• Providing in-person support to patients and families by addressing forms, letters and transportation matters

• This is a fast-paced, high volume, customer service environment. You must be efficient, productive, and thorough when assisting patients and families in person and telephonic. We are looking for team members who have flexibility with some early evening availability

• This role includes rotating weekend coverage every 4-6 weeks and one holiday shift annually

• Dress code corporate casual attire

• Ability to travel up to 10% within the hospital system

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)

• 2+ years of customer service experience

• Intermediate level of proficiency with MS Word, Excel and Outlook

Preferred Qualifications:

• Associates degree

• Experience working within the health care Industry

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

• A clerical or administrative support background

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

#RPO, #RED