Owns the service experience at the field level by working with the Dedicated Customer Service team, and other internal/external matrix partners as required to ensure issues are resolved promptly and accurately meeting Cal. PERS expectations Develop and maintain strong relationship with key internal partners, i.e. Customer Service, Provider Relations, Appeals and Grievance, Eligibility, Billing, Regulatory, Legal, etc. to manage customer service experience and inquiries/escalations Fully accounta... more details
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 to start Caring. Connecting. Growing together.
This role will be part of the Dedicated Account Management team (AMT) managing one client, California Public Employees Retirement System (CalPERS). CalPERS is the largest public employer purchaser of health benefits in CA, second in the nation after the Federal government. They have 1.5M members, 1,500 contracting State and Public agencies and $9.7B in healthcare spend. We currently have ~83k Commercial UHC West/NICE members statewide.
The Service Manager (SM) for Public Sector (PS) is a dedicated "field-based Service Owner" responsible for CalPERS staff, their call center and contracting agencies total service experience with UnitedHealthcare. This includes serving as the key liaison between CalPERS, the Dedicated AMT, Customer Service teams, trending/monitoring of service issue resolution, and education of CalPERS staff, agencies and their employees. The SM is responsible for addressing escalated issues sent to them by the Dedicated AMT, internal/external partners, and CalPERS staff. The SM owns several custom reports due to the client on a monthly basis. He/she will also be responsible to address benefit clarifications/inquiries including Appeals and Grievances received from the client. The SM is also responsible for all addressing surveys or requests for information (RFI) regarding benefits or future legislative mandates received from CalPERS. During open enrollment, will conduct open enrollment meetings as needed or requested.
Primary Responsibilities:
- Owns the service experience at the field level by working with the Dedicated Customer Service team, and other internal/external matrix partners as required to ensure issues are resolved promptly and accurately meeting CalPERS expectations
- Develop and maintain strong relationship with key internal partners, i.e. Customer Service, Provider Relations, Appeals and Grievance, Eligibility, Billing, Regulatory, Legal, etc. to manage customer service experience and inquiries/escalations
- Fully accountable for supporting the Dedicated AMT in facilitating resolution of all escalated customer service requests and working with the Dedicated Customer Service team.
- Attend CalPERS Operational meetings to present monthly trends and keep abreast of any escalating issues and service trends
- Maintain and provide client information to the Director and SAE on service trends, myuhc adoption, and improvement opportunities, etc
- Establish and maintain strong and appropriate relationships with CalPERS staff, agencies and call center to maintain persistency
- Support Sr. FAM with ordering enrollment materials and giveaways for the client
- Coordinate resolution of eligibility issues with the Dedicated Eligibility Analyst
- Coordinate billings inquiries with the Dedicated Billing Analyst
- Special projects as driven by the client, agencies, Call Center and/or AMT
- Attend scheduled virtual or in-person agency visits annually with FAMs
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:
- Health and Life Insurance license as required by law or able to obtain within 30 days
- 2+ years of experience in an account management role within the insurance industry
- Previous experience which demonstrates the ability to work with employers, consumers, consultants, brokers
- Proficiency in Microsoft Word, PowerPoint, and Excel
Preferred Qualifications:
- Public Sector account management experience (government, school systems, cities/municipalities, etc.)
- Demonstrated experience with effective presentation skills in both small and large group settings
- Experience navigating a complex organization to accomplish customer satisfaction
- Proficiency in NICE system
Soft Skills Required:
- Excellent oral and written communication skills
- Advanced analytical and problem-solving skills
- Ability to interface with and influence internal business partners through the use of excellent interpersonal skills
- Solid team player
California Residents Only: The hourly range for this role is $21.63 to $48.08 per hour. Role is also eligible to receive bonuses based on sales performance. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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 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.