Care Team Associate – National Remote

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Care Team Associate (CTA) for concurrent authorization department (census management – CCM) will effectively support the successful implementation and execution of all Utilization Management programs and processes. The Care Team Associate will provide support to the Utilization Management / CM staff to ensure applicable program processes and operational responsibilities are met. The CTA will prepare the authorization by seeking out medical records to the providers via phone or fax, and once completed it is sent to the nurse for review. This position will also provide support in troubleshooting any authorization related issues identified by the Medical Management staff. This position will also assist with training and orientation of new staff and will serve as a subject matter expert for existing staff to ask questions.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST, Sunday – Saturday. It may be necessary, given the business need, to work occasional overtime and weekends.

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

Primary Responsibilities:

• Receives and responds to inquiries from all communication venues: e.g. phone, queue, department e-mail box or fax
• Coordinates and assists initial screening of concurrent authorization requests via all communication venues; as well as administrative preparation for clinical staff
• Exhibits excellent phone and communication skills while providing complete and accurate information to customers
• Requests additional or supplemental information via correspondence in order to complete prior authorization requests
• Completes prior authorizations in the WellMed prior authorization system according to approved policies and procedures
• Compiles and reports data for ongoing key performance indicators and summarizes and presents findings to departmental leadership. Notifies manager of trends they observe
• Adheres to assigned schedule and quality metrics
• Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports
• Provides excellent customer service by serving as a resource to all internal and external customers
• Attends required meetings and participates in special committees as needed
• Assists with training and onboarding of Utilization Management  / CM Care Team Associates
• May act as a team lead for projects and departmental initiatives as assigned
• Performs 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 / GED OR higher
• Must be 18 years of age OR older
• Working knowledge of Microsoft Office Suite, Internet and e-mail
• Ability to work full-time, Sunday – Saturday between 7:00am – 7:00pm CST including the flexibility to work occasional overtime given the business need

Preferred Qualifications:

• Certified Medical Assistant training or certification
• 2+ years of experience with prior authorization or claims
• 2+ years of administrative support experience
• Medical terminology experience
• General knowledge of CPT, and ICD-10
• Microsoft Smartsheet and Microsoft Excel

Soft Skills:

• Able to work independently, with some supervision and direction from manager
• Possess and demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers
• Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
• Maintain strict confidentiality at all times to include but limited to patients and coworkers
• Comply with all organizational policies regarding ethical business practices
• Adhere to all department policies and procedures

Telecommuting Requirements: 

• Ability to keep all company sensitive documents secure (if applicable) 
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy. 
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.