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.

Primary Responsibilities:

• Analyze performance data and conduct effective performance management to drive productivity and quality improvements within the team
• Complete monthly internal audits for direct reports, ensuring accuracy and compliance with company policies and procedures
• Drive education initiatives to improve accuracy and compliance through training sessions and workshops
• Conduct monthly one-on-one performance conversations with direct reports to provide feedback, set goals, and address any performance issues
• Coordinate and supervise daily activities of the team, ensuring tasks are completed efficiently and effectively
• Maintain high standards of work quality and motivate the team to meet or exceed performance targets
• Serve as a point of contact for escalated inquiries from providers, members and business partners, resolving issues and providing exceptional customer service
• Manage the referrals process, ensuring timely outreach and coordination of services between providers and members
• Collaborate with hospitals and clinical teams to triage members, manage administrative intake, and facilitate admissions and discharges
• Regularly communicate and collaborate with other departments and stakeholders to ensure smooth operations and effective teamwork
• Stay updated with industry trends and best practices to continuously improve processes and performance within the team

***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***

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:

• Licensed Registered Nurse, Licensed Clinical Social Worker or Licensed Professional Counselor
• 2+ years of supervisory or team lead experience
• 2+ years of customer service and/or sales experience
• 2+ years of experience with case management, managed care, and / or community support
• Experience working in a team atmosphere in a production driven environment with quality audit standards
• Experience with Microsoft Word, Excel and Outlook (email and calendar management)
• Knowledge of health insurance business and industry terminology
• Bilingual Spanish/English proficiency
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 9:00pm AST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends

Preferred Qualifications:

• Behavioral setting experience (i.e. hospital, managed care organization, or joint behavioral outpatient practice)
• Experience supervising remote employees
• Investigational and / or auditing experience, including government and state agency auditing experience
• Knowledge of health industry regulatory guidelines (CMS, HEDIS, NCQA, others)

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 employers 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.