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.

General Function: The Care Coordinator will effectively support the successful implementation and execution of all Care Management processes. The Care Coordinator will provide support to care management team including CM manager, CM Director, and CM Vice President to ensure applicable program processes and operational responsibilities are met. The CC provides support for Care Management processes. This position is responsible for the daily census management, task management, and general coordination functions. This position will serve as a liaison with internal/external customers/departments to ensure optimal customer service.

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 3990 Concours Ontario, CA.

We offer 3 weeks of paid training. The hours during training will be 9:00 am to 5:00 pm PST, Monday – Friday.

If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions.

Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
Documents all member interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations
Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g., phone queue, CM/UM electronic platform, portal, department e-mail box or RightFax
Coordinates and assists in monitoring of documentation Care Management queues for Disease Management, Transitions of Care, Complex Care, and Social Work referrals
CC processes CM requests via all communication venues; as well as administrative preparation for clinical staff
Conducts in-bound and out-bound calls for program requirements including, but not limited to member scheduling, surveys/screenings, satisfaction/complaints, census management and distribution of materials to appropriate clinical personnel or members
Completes timely data entry of in-bound and/or out-bound call member contact information into software applications
Provides excellent customer service by serving as a resource to all internal and external customers
Attends required meetings and participated in adhoc committees as needed
Maintains knowledge of all health plan benefits, network, NCQA regulations, health plan policies
Identifies opportunities for process improvement in all aspects of member care
Provides effective communication to improve the patient’s health literacy.
Must maintain strict confidentiality at all times
Must adhere to all department/organizational policies and procedures
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 equivalent yrs of experience
Must be 18 years of age or older
Experience with Windows based program including Microsoft Office product- Microsoft Excel, Microsoft Word, Microsoft Teams and Microsoft Outlook
1+ yrs of experience working in a physician’s clinic, healthcare facility or Medical Insurance provider
Ability to multi-task between multiple screens and system
Able to prioritize, plan, and handle multiple tasks/demands simultaneously
Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 5:00 pm PST

Preferred Qualifications:

Medical terminology knowledge

Telecommuting Requirements:

Reside within the state of California
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 skill

Able to work independently, with some supervision and direction from manager
Possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
Ability to maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times

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

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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.

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Care Coordinator - Remote in CA