Overview

Customer Care Service Navigator – Remote Jobs in San Antonio at UnitedHealth Group


Title: Customer Care Service Navigator – Remote

Company: UnitedHealth Group

Location: San Antonio

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doingyour life’s best work.SM

Positions in this function are responsible for providing service navigation for our members eligible for Medicaid, chronic, clinical multi-disease management, episodic health events, or Dual Special Needs Plans (DSNP). The purpose of this role is to support assigned members’ service and sometimes clinical needs to assist in navigating the health system and closing gaps in care. This role is expected to anticipate and help eliminate member hassles, facilitate next best actions, assist with resolution of cost and financial barriers and help ensure access to care/providers.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 6:00pm local time. It may b e necessary, given the business need, to work occasional overtime.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Job Components

As a concierge service structure, navigators serve as the primary point of contact for all customer service issues. Day to day functions include inbound/outbound calls from/to assigned members and member account research with focus on issue resolution. As a navigator you’ll assist with end-to-end issue identification and resolution.

Dual Special Needs Plans (DSNP):This role will work one-on-one with assigned clinical and non-clinical staff supporting members and their caregivers associated with that assignment in a case management capacity, with a primary focus on closing gaps in care. Daily responsibilities include taking an ownership mindset when engaging with assigned panel of approximately 600 members.

Service Led:This role is responsible for supporting members who are experiencing a challenging health event that requires additional interaction with the healthcare system. Health events include, but are not limited to, hip or knee replacement, heart attack or stroke, or a recent cancer diagnosis. In this role, navigators will manage a panel of members and their healthcare needs, address service needs both proactively and reactively, and facilitate a seamless return to steady state

Clinical Led:This role is responsible for coordination of member navigation plans with Optum clinical and non – clinical staff supporting members in the Navigate4Me program including members referred for CHF, DHN, PSU, HPC, Advanced Illness, ESRD and Transplant. This role will work one-on-one with assigned Optum clinical and non-clinical staff and will support members and their caregivers associated with that assignment in a case management capacity.

Medicaid Navigation:This role will work one-on-one with assigned Medicaid eligible members and their caregivers with a primary focus on identifying and supporting member needs in partnership with clinical and case management resources. Daily responsibilities include taking an ownership mindset when engaging with an assigned panel of members, end-to-end ownership and resolution of member issues, and driving positive health outcomes.

HTCT – High To…

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