Specialty Navigator I

Specialty Navigator I
Location: Norwood United States

Hybrid
Requisition number: 2339107
Job category: Medical & Clinical Operations
Overtime status: Non-exempt
Travel: No

Job Description:

Specialty Navigator I at UnitedHealth Group

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Specialty Navigator I

Norwood Massachusetts

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Caring. Connecting. Growing together.

With these values to guide us our people are committed to making a meaningful difference in the lives of those we are honored to serve.

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Specialty Navigator I

Requisition number 2339107

Job category Medical & Clinical Operations

Primary location Norwood MA

Date posted 03172026

Overtime status Non-exempt

Travel No

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 inclusion talented peers comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Join us to start

Caring. Connecting. Growing together.

Reporting to and working under the general direction of the Supervisors and Manager of the department the Specialty Navigator I process referrals and authorizations for Atrius Health patients. Receives inbound requests calls emails faxes etc. as well as from within the work queues. Maintains patient records and continually provides information to patients and specialists.

Schedule

FT 40 hours. Monday - Friday 830am - 5pm.

This is a hybrid role - hybrid schedule to be determined by manager upon hire.

Location

1177 BOSTON PROVIDENCE HWY NORWOOD MA 02062

If you live near NORWOOD MA you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Primary Responsibilities

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

Handle resolution inquiries from members and/or providers. This is high volume customer service environment. Youll need to be efficient productive and thoroughly dealing with our members over the phone

Answers and replies to a large volume of telephone calls faxes and internet queries utilizing and adhering to department scripts and guidelines

Reviews patient record. If referral does not already exist obtain authorization from payer enter information into EPIC. Forwards authorization to specialists office

Keeps patient and facility informed of status referrals updates and process

Obtains authorization from payer websites efficiently and effectively. Keeps log in and credentials

Research questions and concerns from patients assists in resolving any issues as they relate to the referral process

Escalates difficult issues problems etc. to higher level coordinators or supervisory staff

Works with team to ensure timely process of referrals. Participates in team problem solving activities focusing on production and quality

Customer Service

Ability to provide a high level of customer service to patients visitors staff and external customers in a professional service-oriented respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations

Written Communications

Ability to summarize and communicate in English moderately complex information in varies written formats to internal and external customers

Oral Communications

Ability to comprehend and communicate complex verbal information in English to medical center staff patients families and external customers

Teamwork

Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas identifying issues and respecting team members

Accesses only the minimum necessary protected health information PHI for the performance of job duties. Actively protects the confidentiality and privacy of all protected health information they access in all its forms written verbal and electronic etc. taking reasonable precautions to prohibit unauthorized access. Comply with all Atrius Health and departmental privacy policies procedures and protocols. Follows HIPAA privacy guidelines without deviation when handling protected health information

Performs other duties as assigned

What are the reasons to consider working for UnitedHealth Group Put it all together - competitive base pay a full and comprehensive benefit program performance rewards and a management team who demonstrates their commitment to your success. Some of our offerings include

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays

Medical Plan options along with participation in a Health Spending Account or a Health Saving account

Dental Vision Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage

401k Savings Plan Employee Stock Purchase Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Employee Referral Bonus Program

Voluntary Benefits pet insurance legal insurance LTC Insurance etc.

Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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

1 years of customer service experience preferably in a healthcare setting

Intermediate level of proficiency with creating editing saving and sending documents utilizing Microsoft Word and Excel

Intermediate level of proficiency with typing and talking at the same time and navigating through multiple screens

Preferred Qualifications

Experience working within the healthcare industry and with healthcare insurance

Experience working in a metric-driven work environment

Call center experience

A clerical or administrative support background

Knowledge of ICD-9 and CPT codes

Soft Skills

Independence of Action Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seek assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager

Knowledge Ability to demonstrate full working knowledge of standard concepts practices procedures and policies with the ability to use them in varied situations

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

Pay is based on several factors including but not limited to local labor markets education work experience certifications etc. In addition to your salary we offer benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution all benefits are subject to eligibility