Care Management Assistant - Albuquerque, NM

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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)

Primary Responsibilities:
  • Provide direct customer service for care management department including responding to incoming calls to department. Finds solution or refers caller to appropriate team member for assistance
  • Complete outreach calls to patients identified as eligible for Case Management and Disease Management programs
  • Provides verbal confirmations and written documentation of determinations regarding benefit eligibility, authorizations for inpatient admissions and outpatient precertification and/or prior authorization requests
  • Performs electronic eligibility and benefits verification
  • Reviews and routes electronic documentation to clinical staff as needed
  • Coordinates medical appointments with provider clinics
  • Assists with reporting, writing/reviewing workflows, and other projects
  • Maintains up to date knowledge of insurance requirements including in network and out of network, and management of prior authorization process
  • Attends departmental meetings and provides constructive recommendations for areas of improvement
  • 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:
  • Highschool Diploma or GED equivalent
  • 1+ years of experience in customer service role
  • 6 months+ of experience in a the healthcare environment

Preferred Qualifications:
  • Experience working with healthcare insurance
  • Experience in a hospital, physician's office or medical clinic setting
  • Knowledge of medical terminology
  • Excellent communication, interpersonal, organization and customer service skills
  • Ability to multi-task and work under pressure with attention to detail
  • Skilled with MS Office software applications


UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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.

Job Keywords: Clin Admin Coord Sr, Clinical Admin & Processing, Medical & Clinical Operations, Albuquerque, New Mexico, NM

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