Remote Optum Utilization Review Jobs in Boston, MA

This position is Remote in Boston, MA. If you are located within commutable distance to one of the following locations: PO Square-147 Milk Street, Boston, MA; Watertown-485 Arsenal Street, Watertown, MA; Norwood-1177 Providence Highway, Norwood, MA; or Quincy-500 Congress Street, Quincy, MA, you will have the flexibility to work remotely* as you take on some tough challenges.

Explore opportunities with Atrius Health, part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. Our entire team of providers (physicians, PA/NPs and ancillary clinicians) works collaboratively with a value-based philosophy within our group practice as well as with hospitals, rehab and nursing facilities. Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind Caring. Connecting. Growing together.

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 Sunday, 7:30 am to 4:00 pm; Monday - Thursday 8:00 am - 4:30 pm.

We offer 4 weeks of paid training. The hours during training will be 8:00 am - 4:30 pm, Monday - Friday. Training will be conducted onsite.

Primary Responsibilities:

• Screens all incoming patient inquires (through phone, online/medical record message, or other means) to determine whether those inquiries can be appropriately handled by the Patient Service Representative or if they need to be directed to other team members
• Courteous, friendly, problem solver with customer service, patient focused communication
• Resolves issues in areas involving patient satisfaction, patient flow, and compliance with procedures and guidelines. Advocates for patients as appropriate
• Participates in resolving operational difficulties and communicates with supervisor regarding department issues and problems as necessary
• Resolves patient issues and ensures satisfaction. May refer difficult or highly complex phone calls and issues to higher level staff
• Initiates requests for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients and answers any corresponding questions. Understands all documents and processes
• Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance
• Develops and maintains effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies
• Reviews department appointment schedules to ensure that clinic utilization is optimized and effectively supports the needs of the clinics as well as the needs of the patients
• Assists with basic data collection activities, ensuring data is properly collected and accurate (e.g. no show reports, telephone statistics)
• Participates in problem solving activities, focusing on productivity and quality.  Works with supervisors to ensure continuous improvement of the department
• Participates in special projects and ongoing programs unique to the department

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 equivalent work experience 
• Must be 18 years of age OR older
• 1 years of customer service experience
• Electronic medical record (EMR) experience and/or aptitude to master the EMR based on other technology experience
• Experience booking, rescheduling, and canceling appointments; and verifying patient eligibility using digital scheduling platforms.
• Proficient in Microsoft Outlook, Microsoft Teams, Microsoft Word, and Microsoft Excel for communication, scheduling coordination, reporting, and internal collaboration.
• Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of Sunday, 7:30 am to 4:00 pm; Monday - Thursday 8:00 am - 4:30 pm.

Preferred Qualifications:

• 1 years of experience working in a clinical setting
• Working knowledge of patient related documents

Telecommuting Requirements:

• Reside within commutable distance to the office at 147 Milk St., Boston, MA 2109
• 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.

Soft Skills:

• Good time management skills
• Well organized 
• Ability to problem solve
• Ability to multi-task
• Strong communication skills
• Strong attention to detail

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy  

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.15 - $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO