Position Description:Welcome to one of the toughest and mostfulfilling ways to help people, including yourself. We offer the latest tools,most intensive training program in the industry and nearly limitlessopportunities for advancement. Join us and start doing your life's best work.We dedicate an elite team of Advisors to serve our United Healthcare Families of Children with Special Needs because we recognize that the health care system needs to be tailored to work for every individual and family to best serve their specific needs. When you join us as an Advisor, you'll have the opportunity to deliver an extraordinary experience to families who need an ally; someone in their corner that is empowered to fast track resolving issues and serves as an ongoing resource to provide guidance and community resources during key transition times in each family's journey. Some issues you will help families resolve include complex benefit, claims and billing issues, prior authorizations, appeals and more.What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.Primary Responsibilities:Provide holistic family support to families of children with special needs, owning end - to - end resolution of benefit issuesServes as an ongoing, single point of contact for members, primarily via the phone channel (may also will use email, chat, text), delivering compassionate support to consumers, creating a memorable, positive consumer experience. Must create and build ongoing relationships with others (to include both consumers and teammates)Make decisions independently and solve problems creatively without requiring established procedures, using sound judgment and critical thinking, while consistently following through on commitments and framing realistic expectations for consumersPlans, prioritizes, organizes and completes work to meet established objectivesMentors and coaches colleagues, and acts as a resource for othersAnticipates member needs and proactively seeks out external and internal resources where appropriate to add unexpected value for the member. Ability to determine appropriate referrals to other programs / services as needed without technology guidanceProactively identifies areas of improvement for the broader member experience and escalates the issue and proposed solution for the benefit of the entire teamOngoing education for conditions that fall under the special needs umbrella is required; Will be on the job and provided by UHGProvide other services in the future yet to be defined. For example: decision support servicesContributing to the community of the team, being vocal with what you have learned.Provide services such as:End to end resolution of coordination of benefits, and medical & pharmacy claims, billing/appeals / prior authorization / etc. issues; striving to remove the burden from the consumerHelp members with medical, behavioral and pharmacy needs as well as connect them with resources in and out of our companySupport in researching and identifying healthcare providers that meet and align with consumer needsEducate and coach consumers on clinical, wellness and community resources they can use to help increase their family's quality of lifeEducate consumers on their benefit package and quarterback interactions to additional benefit experts or resources; Expected to do much more legwork on the member's behalf and not transferIntervene with care providers (healthcare provider offices) on behalf of the consumer to assist with appointment scheduling or connections with internal specialists for assistance when neededAssist consumers in navigating myuhc.com and other UnitedHealth Group resources and encourage and educate them to become self - sufficientProvide resources and guidance to help members navigate key transition times in their dependents' life, when benefits and resources typically changeTo succeed as a Special Needs Family Advisor, ideal candidates will possess:Be passionate about helping individuals and families of children with special needs. Strong empathy, compassion and listening skills Aptitude to be proactive, resourceful and relentless with solving issues and providing support; can think outside the boxHave critical thinking and problem solving skillsBe a self - starter and thrives in ambiguity without established processes; Adaptable and driven to improve process.Have strong communication skills with an ability to understand many different special needs conditions, the impact on the family and then tailor approaches to a variety of unique individuals. Able to diffuse consumer distress and manage complex situations as well as prioritize actions, excellent writing skills, and the aptitude to translate complex benefit terminology and processes into common language consumers can understand and act upon Have strong organizational skills in an effort to prioritize tasks effectively and efficiently Work well on a teamMust be willing to stay abreast of current special needs services trends for proper delivery of servicesThe ability to be laser - focused on putting consumers needs at the center of decisionsAptitude to translate complex benefit terminology and processes into common language consumers can understand and act uponFlexibility to continuously evolve the role and try new thingsAgility in order to excel in a very fast - paced work environment with constant learning and change
Required Qualifications:High School Diploma / GEDAbility to work Monday - Friday for 8 hour shifts between the hours of 7:00 AM - 8:00 PM CST1+ years of experience helping, resolving, or advocating on behalf of consumers or customersExperience using computer and Windows PC applications (MicrosoftExcel, Word and Outlook) to create, copy, edit, save and send documentsPreferred Qualifications:Bachelor's Degree (or higher) in a Social Science field Experience providing care for children with special needsClaims processing experience Experience within a Service Delivery capacity (examples include, but are not limited to: Social Services, Caregivers, Hospitality, Social Work, Sales, Non - Profit Agencies)1+ years of experience working in healthcareBilingual with English and Spanish Soft Skills:Strong keyboard experience, Navigation skillsAdeptness inlearning new computer programsThe ability to type and talk at the same timeand toggle between multiple screensCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SMDiversity 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. Keywords: UHG, Green Bay, Healthcare, Advisor, SPECIALNEEDS
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.