Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff, and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

　　Under the supervision of the Correspondence UM Supervisor, this position is responsible for processing Utilization Management (UM) Letters Inventory. Correspondence UM Coordinator is responsible for handling customer service or provider calls as needed. Coordinates UM processes with WellMed Medical Directors, UM Nurses, hospitals, physicians, and other various departments. Correspondence UM Coordinator is responsible for providing clerical support to WellMed clinical staff for their medical necessity review process. Correspondence UM Coordinator is expected to maintain production and quality standards.

　　This is a fast-paced environment that requires working various shift hours and rotating/required weekends and holidays.

　　You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Must be able to work central standard times between 7:00am until 6:00pm, weekends and holidays. 4 10-hour shift schedule.

　　Primary Responsibilities:

　　Process UM notification according to standard operating procedures and job aids while meeting productivity and quality standards to include: TruCare queues Information received through Right Fax Information received through email Or any other methods of receipt (phone calls, etc.) Process the correct health plan letters in the system of record, if applicable verify grade level Process the correct health plan letters manually and document in the system of record Process the correct health plan letter in the preferred language Process overnight labels for the letters when applicable Process return mail retrieved from the mailroom Process Health Plan and QIO appeals Exhibits excellent communication skills while providing complete and accurate information to customers Requests additional or supplemental information via correspondence in order to complete UM notification requests Prepares administrative files for Medical Directors, UM Nurses, and Case Managers Documents and follows-up on all assigned inventory, utilizing on-line systems and procedures, according to established guidelines Maintains knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies Utilize experience and judgement to plan, accomplish goals and effectively resolve each assigned task Print, feed, and retrieve letters from the folding machine Metered mail is handled according to processes and procedures Attends required meetings and participates in special committees as needed Performs all other related 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:

　　High School Diploma / GED (or higher) 2+ years of administrative support experience 6+ months of knowledge / experience with medical terminology Intermediate level of proficiency with Microsoft Office applications, i.e., Excel, Access, Word, and Outlook Ability to work one of the available shifts: Wed-Sat, from 7am-6pm CST or Sun-Wed, from 7am-6pm CST

　　Preferred Qualifications:

　　Certified Medical Assistant training or certification 2+ years of experience with prior authorization or claims ICD-9/ICD-10 and CPT knowledge

　　 Soft Skills:

　　Proven ability to work independently, with some supervision and direction from manager Proven exceptional ability to organize, prioritize and communicate effectively Proven ability to provide excellent customer service to a varied customer base Proven ability to navigate multiple systems Proven ability to work in a fast-paced environment

　　Physical & Mental Requirements:

　　Ability to stand for extended periods of time Ability to properly drive and operate a company vehicle

　　All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

　　California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, or Washington residents is $16.00 to $31.44 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

　　Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

　　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.

　　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.

　　#RPO #Green