Premier Customer Service Advocate - Remote in Richardson, TX
Company: UnitedHealth Group
Location: Forney
Posted on: September 20, 2023
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Job Description:
If you are located within 50 miles radius from Richardson, TX
office, you will have the flexibility to telecommute* (work from
home) as you take on some tough challenges.
At UnitedHealthcare, we're simplifying the health care experience,
creating healthier communities and removing barriers to quality
care. The work you do here impacts the lives of millions of people
for the better. Come build the health care system of tomorrow,
making it more responsive, affordable and equitable. Ready to make
a difference? Join us and start doing your life's best work.SM
The role of the Premier Super Advocate is to support and handle
complex member scenarios as well as follow and support members with
more complex and/or chronic medical conditions requiring higher
system utilization by identification through contacts with the call
center. - The Super-Advocate's responsibility is to provide
resolution for escalated and repeat calls and focus on members who
are/have the potential for higher system utilization to provide
evidence-based support and services
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 10:35am
- 7:05pm CST. It may be necessary, given the business need, to work
occasional overtime. Our office is located at 1311 W Pres George
Bush Highway, Richardson, TX, 75080.
We offer 18 weeks of training. The 1st week of training will be
onsite (The hours during training will be 8:00 AM - 4:30PM CST from
Monday - Friday) and then training will continue remote for the
rest of the 17 weeks (The hours during training will be 8:00 AM -
4:30PM CST from Monday - Friday). Additional 30 days post training
required to come onsite (The hours during training will be 8:00 AM
- 4:30PM CST from Tuesday - Thursday). 100% attendance is required.
NO PTO.
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
Primary Responsibilities: -
Provide premium or elite level, proactive support, and service with
end-to-end resolution for members, using their preferred
communication method.
Resolve escalated and complex calls/claim adjustments/issues from
members that front line advocates are unable to resolve or need
assistance on, working directly with business partners to make
decisions regarding claim reconsiderations, prior authorizations,
and appeal considerations.
Engage in real time collaboration with appropriate clinical
partners to resolve member concerns, connecting them with clinical
programs and resources as needed.
Act as a Subject Matter Expert (SME) for benefits and claims (Call
& Digital) to provide real time guidance to advocates who may need
help to resolve a member issue. Act as the primary contact for
Service Account Managers.
Provide support, coaching, technical training and feedback to other
advocates regarding best practices. Work with supervisors to
suggest or identify training or resource needs to enhance
performance and manage ORS inventory at the team/client level.
Identify gaps in process, work with business partners to determine
new processes, write/communicate process changes.
Own relationships and interactions with chronic issues or complex
client micro populations such as Special Needs or Transgender
members providing end to end resolution for members, using their
preferred communication method.
Facilitate proactive outbound calls when necessary to educate
members on the best use of the benefits, to welcome new members to
UHC, etc., owning the close-loop process.
Research complex issues across multiple databases and work with
support resources to resolve member issues and/or partner with
others to resolve escalated issues.
Meet the performance goals established for the position in the
areas of conversation effectiveness, call quality, member
satisfaction, first call resolution, proactive member engagement
with clinical referrals, lower cost Rx alternatives, portal
promotion, provider steerage to in-network providers, efficiency,
and attendance.
Support escalated members and staff when a member asks to speak to
a supervisor, or the front-line advocate needs assistance in
de-escalating an upset member. -
Perform all job functions required as an Elite or Premier
Advocate.
Complete outbound calls to close the loop with members who express
dissatisfaction with issue resolution or service via the post call
survey after speaking to an advocate.
Work with partners including medical, clinical, financial,
behavioral and Rx to resolve issues as needed.
Maximize use of community services, support programs and resources
available to the member
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) OR equivalent work
experience
Minimum of 1+ years of experience helping, resolving, or advocating
on behalf of members or customers
Experience using a computer and Microsoft Office including
Microsoft Word (create correspondence and work within templates),
Microsoft Excel (ability to sort, filter, and create simple
spreadsheets), and Microsoft Outlook (email and calendar
management)
Ability to work 40 hours per week Monday through Friday, 10:35am -
7:05pm CST
Preferred Qualifications:
Health Care/Insurance environment (familiarity with medical
terminology, health plan documents, or benefit plan design)
Social work, behavioral health, disease prevention, health
promotion and behavior change (working with vulnerable
populations)
Sales or account management experience
Customer Service/Advocate Experience
Claims processing experience
Experience within a member focused healthcare environment
Telecommuting Requirements:
Reside within 50 miles radius from Richardson, TX
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 Skills:
Exceptional written and oral communication skills adaptable to live
phone conversations as well as e-mail or chat exchanges that drive
a trusted relationship based on ownership reducing customer
effort
Ability to quickly build rapport and respond to members in a
compassionate manner by identifying and exceeding member
expectations (responding in respectful, timely manner and
delivering on commitments)
Ability to listen skillfully, collect relevant information,
determine immediate requests, and identify the current and future
needs of the members
Proficient problem-solving approach to quickly assess current state
and formulate recommendations
Flexibility to customize approach to meet all types of member
communication styles and personalities
Ability to overcome objections and persuade members to take action
/ change behavior
Proficient in translating healthcare-related jargon and complex
processes into simple, step-by-step instructions members can
understand and act upon
Excellent conflict management skills including:
Professionally and adeptly resolving issues while under stress
Diffuse conflict and member distress
Demonstrate personal resilience
Ability to utilize multiple systems/platforms while on a call with
a member - strong computer skills and technical aptitude
Strong attention to detail
Strong ability to view change and transition in a positive way, and
easily adapt to all updated requirements of the role
Contribute to achieving the company's mission.
Show commitment to team success over personal success. Work
collaboratively with others to achieve goals
Model UnitedHealth Group's Principles of Integrity and Compliance,
and adhere to our business principles
Maintain the confidentiality of sensitive information
At UnitedHealth Group, our mission is to help people live healthier
lives and make the health system work better for 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.
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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 #YELLOW
Keywords: UnitedHealth Group, Dallas , Premier Customer Service Advocate - Remote in Richardson, TX, Hospitality & Tourism , Forney, Texas
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