Clinical Quality LPN - Remote in CST or MST
About the position 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 Patient Navigator will be responsible for conducting outbound calls and answer inbound calls, off-season survey follow-up, provide patients with community resources, close gaps on HOS, etc. for all markets as needed. The Patient Navigator will support a variety of strategic activities, based on Member Experience data and performance metrics throughout the OptumCare enterprise. This individual will maintain the highest standards to ensure the members have the best healthcare experience by facilitating the process every step of the way, and will complete daily activities reports. Schedule: Monday - Friday (No weekends, no holidays). Must be flexible to work hours in different times zones as needed for a nationwide account. If you are located in CST, you will have the flexibility to work remotely as you take on some tough challenges. 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.
Responsibilities
- Conduct a high volume of outbound calls to assist members, evaluate current health status, discuss non-compliance to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed
- Answer inbound calls from members and assists them with their inquiries
- Identifies patients with the missing measures and works to close the measures through education/counseling, appointment setting, and other means as appropriate
- Follows system scripting and validates member demographic information
- Documents the provider or member's record with accurate information obtained on the call
- Maintains education/knowledge base of HEDIS/STARs standards and guidelines
- Uphold UHG Cultural Values
- Ability to multitask and performs all other related duties as assigned
Requirements
- Current, unrestricted LVN/LPN license
- 3+ years of clinical experience as a LVN or LPN
- 3+ years of experience in the health industry and/or in a large complex matrixed organization
- Intermediate level of proficiency with MS Excel, Word, and PowerPoint– Project scope documents, project presentations, etc.
- Intermediate level of proficiency with SharePoint
Nice-to-haves
- Experience in a call center
- HEDIS/STAR experience or participation with similar regulatory reporting
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Benefits
- 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.
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