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Outreach Coordinator - Albuquerque, NM


Clinical Coordinator


Albuquerque, New Mexico, United States

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

Provides direct customer service for assigned departments to include but not limited to referrals, scheduling, verifying insurance, obtaining and processing patient data, and obtaining pre-certification for necessary referrals/procedures that require prior authorization. Handles customer account transactions, provides customer assistance, and interfaces with multiple clinics. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.

Primary Responsibilities:

  • Provides direct customer service for assigned departments to include but not limited to obtaining referrals, reviewing referral worklists to include reviewing patients referred outside of the group for selected specialties, scheduling and verifying insurance
  • Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff
  • Performs electronic eligibility verification, updating patient demographics, ensure required referrals and prior authorization are in place for patient visit
  • Answer questions from patients regarding the status of their scheduled appointments. Mail fax, or communicate appropriate records, certification and authorizations to appropriate persons for the completion of scheduling
  • Explain the process of the CWC wellness visit to patient including, but not limited to what is involved, who the provider is, and the location of the specialist office. Ability to directly schedule patients into all listed clinics to ensure a seamless transition for patients
  • Responsible for obtaining “expert” level knowledge of the inter-workings of various insurance plans especially Medicare Advantage plans
  • Responds effectively to incoming patient calls and communicates pertinent information to physician or designee to provide for continuity and optimal care
  • Attends departmental meetings and provides constructive recommendations for areas of improvement
  • Appropriately communicates physician orders and instructions to patients
  • Documents pertinent patient information in the electronic medical record as it relates to job function
  • Coordinates with various providers, team members and outreach team regarding any scheduling guidelines
  • Meets established productivity, schedule adherence, and quality standards
  • Other duties as assigned

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 or GED equivalent
  • 1+ years of previously related experience
  • Knowledge of medical terminology
  • Solid computer skills

Preferred Qualifications:

  • Excellent communication, organization and customer service skills
  • Bilingual
  • Self-motivated
  • Proven ability to problem-solve
  • Solid attention to detail
  • Ability to manage time effectively and work independently

Physical Demands:

  • Standing
  • Sitting
  • Walking
  • Kneeling/Crouching
  • Lifting

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)

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.

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.