Job Abstract

If you are located within a 50-mile commutable distance of 1 Tower Center Blvd., 11th Floor, East Brunswick, NJ, 08816, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

At UnitedHealthcare, were 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 lifes best work.^SM

UnitedHealthcares highly skilled team of Senior Complex Care Customer Service Representatives is dedicated to serving and managing special needs for our members and / or their family members. When you join our team as a Senior Complex Care Customer Service Representative, you will have the opportunity to deliver an extraordinary experience to family members who need an ally. Senior Complex Care Customer Service Representatives are empowered to fast track resolutions and serve as an ongoing resource to provide guidance and community resources during key transition times throughout the familys journey. Some of the issues you will help resolve include complex benefits, claim and billing issues, prior authorizations, appeals, and more.
You will make an impactful and meaningful difference for many individuals and families. This is where you can bring your compassion for others while doing your lifes best work.^SM

This position is full-time (40 hours / week), Monday - Friday. Employees are required to work during our normal business hours of 8:00 AM - 5:00 PM. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 1 Tower Center Blvd., 11th Floor, East Brunswick, NJ, 08816. You will have the availability to work from home but may be required to come into the office for meetings and for training.

We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.

*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

Primary Responsibilities:

• Provide holistic family support to members who may have special needs themselves or may be caring for children or family members with special needs, owning end - to - end resolution of issues.
• Serve as an ongoing, point of contact for members, primarily via the phone channel (may also will use email, chat, text), delivering compassionate support to members, creating a memorable, positive experience.
• Create and build ongoing relationships with others including both members and teammates.
• Make decisions independently and solve problems creatively and completely using sound judgment and critical thinking.
• Consistently follow through on commitments and framing realistic expectations for members.
• Plan, prioritize, organize and complete work to meet established objectives for our families.
• Responsible for managing project time to insure follow up and outreach work is completed in a timely manner.
• Families served include a range of low, moderate and high needs as determined by clinical needs, financial impacts, and / or level of escalation.
• Process includes outreach calls to initiate contact with members referred by executives and partners.
• Responsible for maintaining accurate family counts on our documentation platform.
• Focus on teamwork and fostering strong team environment through activities including mentoring and acting as a resource for colleagues.
• Anticipate member needs and proactively seek out external and internal resources or partners where appropriate to add unexpected value for the member.
• Determine appropriate referrals to other programs / services as needed with or without technology guidance.
• Responsible for providing high quality member experience as reflected in post contact surveys and member feedback.
• The national team will make initial calls to members and Senior Complex Customer Service Representatives will be the secondary tier of support once national team has completed their process.
• Membership related advocate responsibilities.
• Provider related responsibilities.

To succeed as a Senior Complex Care Customer Service Representative, ideal candidates will possess:

• Passion for helping individuals and families of children with special needs.
• Strong empathy, compassion and listening skills.
• Aptitude to be proactive, organized, resourceful and relentless with solving issues and providing support; can think outside the box.
• Critical thinking and problem - solving skills, able to prioritize time efficiently.
• Self - starter abilities and thrive in ambiguity without established processes.
• Motivation to improve process.
• Strong written and verbal communication skills with an ability to understand many different special needs conditions, the impact on the family and then tailor approaches to a variety of unique individuals.
• Ability to diffuse member distress, manage complex situations and the aptitude to translate complex benefit terminology and processes into common language members can understand and act upon.
• Ability to work well within a team.
• Strong focus on putting members needs at the center of decisions.
• A drive to add value by delivering more than the customers expect.
• Agility and flexibility in order to excel in a very fast-paced work environment with constant learning and change.
• Ability to step in with new members, quickly review history and confidently speak to member needs.
• Energy for what needs to be done and for overcoming challenges.
• A coachable mindset focused on professional development and able to implement constructive feedback and coaching.
• Highly skilled at de - escalation techniques; able to move conversations toward building trust.
• High emotional intelligence: able to separate self from complaints / escalated members and focus on delivering thoughtful, compassionate care and resolving issues.

Youll 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 equivalent work experience
• 1+ years of experience with helping, resolving, OR advocating on behalf of members OR customers
  
• Experience with 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)
• Highly skilled at de - escalation techniques
• Ability to work any shift between the hours of 8:00 AM - 5:00 PM from Monday - Friday including the flexibility to work occasional overtime and weekends based on business need
• Must be 18 years of age OR older

Preferred Qualifications:

• 1+ years of Advocate4Me experience OR 3+ months of Quick Assist experience
• Claims processing experience
• Experience within a member - focused healthcare environment
• Experience within a service delivery capacity (examples include, but are not limited to: social services, caregivers, hospitality, social work, sales, non - profit agencies)

Telecommuting Requirements:

• Reside within a 50-mile commutable distance of 1 Tower Center Blvd., 11th Floor, East Brunswick, NJ, 08816
• 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

New Jersey Residents Only: The hourly range for this is $19.47 - $38.08 per hour. Pay is based on several factors including but not limited tolocal 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, youll 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 At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location, and incomedeserves 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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