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Job Details


UnitedHealth Group

Lead Customer Service Rep - Telecommute (107410175)

Customer Service

Customer Service

Yearly

No

Phoenix, Arizona, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

Positions in this family have the primary responsibility of providing telephonic customer service.

Positions in this function are responsible for providing expertise and customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries.

General Job Profile

  • Extensive work experience, possibly in multiple functions
  • Work does not usually require established procedures
  • Works independently
  • Mentors others
  • Acts as a resource for others.- Coordinates others' activities

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Applies knowledge/skills to complex activities
  • Demonstrates a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function.- Often acts as a technical resource to others in own function
  • Anticipates customer needs and proactively identifies solutions
  • Solves complex problems on own; proactively identifies new solutions to problems
  • Plans, prioritizes, organizes and completes work to meet established objectives
  • Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function


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 Qualification:

  • High school education or equivalent experience
  • MS Office experience
  • Experience in a leadership role

Functional Competency & Description

  • Provide Phone Support to Drive Resolution of Caller Questions/Issues
  • Demonstrate understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
  • Ask appropriate questions and listen actively to identify underlying questions/issues (e.g., root cause analysis)
  • Gather appropriate data/information and perform initial investigation to determine scope and depth of question/issue
  • Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed
  • Proactively contact external resources as needed to address caller questions/issues (e.g., providers, labs, brokers)
  • Utilize appropriate knowledge resources to drive resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
  • Identify and communicate steps/solutions to caller questions/issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
  • Offer additional options to provide solutions/positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)
  • Make outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, pharmacies)
  • Drive resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
  • Ensure proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution)
  • Develop and Maintain Productive Relationships/Interactions with Callers
  • Manage caller conversations appropriately (e.g., provide a good first impression, command attention and respect, maintain professional tone, demonstrate confidence, de-escalate/defuse callers as needed)
  • Apply knowledge of applicable Service Level Agreements (SLAs) and Performance Guarantees when interacting with callers -Maintain ongoing communications with callers during the resolution process to communicate status updates and other required information
  • Maintain focus on caller interactions without being distracted by other factors (e.g., system usage, pop-up alerts, VCC data)
  • Acknowledge and demonstrate empathy/sympathy with callers' life events (e.g., wedding, birth of baby, loss of relative, recent illness)
  • Demonstrate Business/Industry Knowledge
  • Demonstrate knowledge of applicable health care terminology (e.g., medical, dental, behavioral, vision)
  • Demonstrate knowledge of applicable products/services (e.g., benefit plans, disability, COBRA, FSA, HRA)
  • Obtain and apply knowledge of benefit structures/designs for contracted or acquired companies
  • Ensure compliance with applicable legal/regulatory requirements (e.g., HIPAA, state/regional requirements)
  • Maintain knowledge of information/process changes due to healthcare reform, referring to applicable company resources (e.g., dependent age, removal of lifetime limits, free preventive care services, Medical Loss Ratio)
  • Demonstrate knowledge of established workflows and support processes (e.g., available resources, internal/external business partners, points of contact)
  • Demonstrate knowledge of relevant internal processes impacting caller issues (e.g., claims processing, auto-adjudication)
  • Identify inaccurate/inconsistent information found in systems/tools, and communicate to appropriate resources (e.g., IBAAG, SOP, AYS, SPDs, policies/procedures)

Values Based Competencies

  • Integrity Value: Act Ethically
    • Comply with Applicable Laws, Regulations and Policies
    • Demonstrate Integrity
  • Compassion Value: Focus on Customers
    • Identify and Exceed Customer Expectations
    • Improve the Customer Experience
  • Relationships Value: Act as a Team Player
    • Collaborate with Others
    • Demonstrate Diversity Awareness
    • Learn and Develop
  • Relationships Value: Communicate Effectively
    • Influence Others
    • Listen Actively
    • Speak and Write Clearly
  • Innovation Value: Support Change and Innovation
    • Contribute Innovative Ideas
    • Work Effectively in a Changing Environment
  • Performance Value: Make Fact-Based Decisions
    • Apply Business Knowledge
    • Use Sound Judgement
  • Performance Value: Deliver Quality Results
    • Drive for Results
    • Manage Time Effectively
    • Produce High-Quality Work


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $18.17 to $32.26. The hourly range for Connecticut / Nevada residents is $20.00 to $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/AffirmativSe 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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