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in Waltham, MA

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Hours Full-time, Part-time
Location Waltham, Massachusetts

About this job

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)



Let's face it, no industry is moving faster than health care. And no organization is better positioned to move health care forward than UnitedHealth Group. We're out to use data, technology and people in ways that help drive change and make the health care system work better for everyone. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 5 industry leader.



Primary Responsibilities:




  • Act as a Subject Matter Expert for other team members

  • Manage the intake of members or the admission/discharge information post notification

  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services

  • Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles

  • Resolve inquiries from members and/or providers



Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you'll also be the “go-to” resource for information. The flexibility to work evening hours will also be required.



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:




  • HS Diploma or GED

  • 2+ years of experience analyzing and solving customer problems

  • Experience working in the health care industry

  • Experience working with medical terminology

  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation



Preferred Qualifications:




  • Experience working with health care insurance

  • Experience in a hospital, physician's office or medical clinic setting

  • Experience working with Medicare and/or Medicaid Services

  • Clerical or administrative support background or experience working in a call center environment





To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.



Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)





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.