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Care Coordination Navigator - Duluth, MN

UnitedHealth Group Duluth, MN Full-Time
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Welcome to one of the toughest and most fulfilling ways tohelp people, including yourself. We offer the latest tools, most intensivetraining program in the industry and nearly limitless opportunities foradvancement. Join us and start doing yourlife's best work.SM


This service model simplifies the way consumers and their families engage in health care - clears the confusion, enables access to the right care, helps ensure the right care decisions are made and makes health care more affordable. 

The Care Coordination Navigator is responsible for providing compassionate customer service and issue resolution to our members. Direct phone - based customer interaction to answer and resolve a wide variety of inquiries. This role is responsible for coordination of member navigation plans with health plan clinical and non-clinical staff supporting members enrolled in DSNP benefits including members, or families with members, identified as having complex illness. 


This position is full-time (40 hours/week) Monday- Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 7:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 4316 Rice Lake Road, Duluth, MN 55811.


Primary Responsibilities:

  • Provide concierge and white-glove level service, removing burdens and providing end-to-end resolution for customers
  • Serve as a single point of contact for the customer and form a strong relationship to support them
  • Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
  • Research complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experience
  • Respond to and own consumer inquiries and issues
  • Conduct proactive research on assigned member accounts to identify service issues
  • Identify gaps in processes and work closely with other departments for process improvement
  • Provide education and status on previously submitted pre-authorizations or pre-determination requests
  • Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance 

This is high volume, customer service environment. You’ll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes.

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)
  • 4+ years combined education and/or volunteer, internship or work experience including one of the following:
    • High school diploma or GED and 4+ years experience in customer service, coaching, or guiding internal or external customers
    • Associate’s degree and 2+ years experience in customer service, coaching, or guiding internal or external customers
    • Bachelor’s degree (or higher) and 6+ months experience in customer service, coaching, or guiding internal or external customers 

Preferred Qualifications:

  • Undergraduate Degree (or higher)
  • Experience in health care/insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
  • Experience in social work, behavioral health, disease prevention, health promotion and behavior change  (working with vulnerable populations)
  • Sales or account management experience

    Careers at UnitedHealthcare Community & State. Challenge brings out the bestin us. It also attracts the best. That's why you'll find some of the mostamazingly talented people in healthcare here. We serve the healthcare needs oflow income adults and children with debilitating illnesses such asCardiovascular Disease, Diabetes, HIV / AIDS and High - risk Pregnancy. Ourholistic, outcomes - based approach considers social, behavioral, economic,physical and environmental factors. Join us. Work with proactive Healthcare,Community, and Government partners to heal healthcare and create positivechange for those who need it most. This is the place to do your life’s best work.SM

    Diversity creates a healthier atmosphere:UnitedHealth Group is an Equal Employment Opportunity / Affirmative Actionemployer and all qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex, age, national origin, protectedveteran status, disability status, sexual orientation, gender identity orexpression, marital status, genetic information, or any other characteristicprotected by law.

    UnitedHealthGroup is adrug - free workplace. Candidates are required to pass a drug test beforebeginning employment.

    Keywords:customer service, call center, advocate, healthcare, benefits, UHG, UHC, CSR,health care, phone support, concierge, coaching, Duluth, MN, Hermantown, MN,Superior, WI

     

    Recommended skills

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