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Job Details

UnitedHealth Group

Business Operations Specialist


Clinical Care Specialist/Staff Nurse


Franklin, Tennessee, 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's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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

Primary Responsibilities:

  • Contact providers, hospitals and/or clinical staff via phone and email to explain program and request, set commitments for information return, and explain options for completing and transmitting information
  • Develop and manage on-going relationships with designated providers to reduce provider abrasion, drive program participation and enhance productivity and efficiency
  • Collaborate with a third-party retrieval vendor in order to successfully release medical record request for providers/hospitals
  • Manage PHI and provider outreach
  • Make approximately 40 outbound calls daily and meeting program specific metrics to be outlined by leadership
  • Your day to day will consist of 80% telephonic outreach and 20% written communication and provider data research
  • Respond to monitoring coaching and various forms of feedback and quality analysis to meet or exceed performance metrics
  • Adhere to Protected Health Information PHI policies and practices

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) OR 4+ years of administrative, clerical, or customer service experience in an office setting
  • 5+ years of experience utilizing MS Office applications, including Word and Excel
  • 3+ years of experience in an administrative, clerical, or customer service experience in an office setting using phones and computers as the primary job tools
  • 6+ months of experience with online research

Telecommuting Requirements:

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)

Soft Skills:

  • Ability to compose grammatically correct correspondence that translates program expressions into simple terms that the office contact can easily understand
  • Ability to use negotiation skills to encourage the office contact to return the medical records timely
  • Effective communication skills and an articulate and professional phone presence
  • Ability to apply creative thinking skills when needed to resolve questions as it relates to Provider Claim Review
  • Ability to thrive on change, to adapt to multiple focuses in short amounts of time
  • Ability to work independently, apply critical thinking skills when needed, multi-task and demonstrate professionalism in all interactions

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)

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

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 to $32.26. The salary 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.

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.