If you are located within 50 miles of 1145 Westmoreland Drive El Paso, TX 79925, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

Cuando se trata de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial de carrera! Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do. Or, the opposite, not being able to get the answers. At UnitedHealth Group, we want our customers to get those answers by speaking to one of our Bilingual Representatives. If you're fluent in English and Spanish, we can show you how to put all of your skills, your passions and your energy to work in a fast - growing environment.

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

The Bilingual (English / Spanish) Clinical Administrative Coordinator will provide administrative support to Service Coordinator to assist in the delivery member services non-waiver and waiver, initiation of member contact, provision of member and provider education and coordination of community resources to promote optimal health.

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 - 5:00pm MST). It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 1145 Westmoreland Drive El Paso, TX 79925.

We offer on-the-job paid training. The hours during training will be 8:00am to 5:00pm MST, Monday - Friday. Training will be conducted once a month on site.

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

Primary Responsibilities:

• Answers incoming fax, email and phone requests as evidenced by fax log, inbox, and event tracking.
• Initiates member phone calls daily and identifies issues and refers to service coordinator and other health plan departments as indicated. Documents in current service coordination system.
• Accurately schedules, cancels, and documents new and/or follow-up appointments for both face to face and telephonic requests, as needed for service coordinator and other designated team members as identified in service coordination system.
• Receives initial incoming faxes, emails, or phone requests into the department, gathering demographic and benefit data, documenting in appropriate system, and evaluating if the request needs to be referred to a registered nurse, social worker, or transition specialist. This is determined through documented policy and procedure.
• Screens and evaluates all calls and refers as necessary to service coordinator and/or supervisor.
• Gathers data for statistics by product, service, and network and maintains all required logs.
• Manages the intake of MNLOC and ISP request of identified members.
• Monitors portal to ensure initial assessments and reassessments are completed timely.
• Communicates in progress MNLOC reviews submitted.
• Monitor portal for approval or denial decisions on MNLOC / ISPs
• Document decisions into OICS and provides communication to the Service Coordinator of the outcome.
• Update due dates for the ISP and MNLOC in service coordination system.
• Completes all eligibility and benefit data available on members before routing to service coordinator or transition specialist.
• Assists internal and external departments by providing communication and education regarding case management and transition services and processes.
• Provides input on the availability and accessibility of case management and transition services.
• Provides ongoing education with members regarding managed care and benefits.
• Provides education to members regarding EL Paso Health network, access, community resources, and basis health information.

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:

• High School Diploma / GED and / OR equivalent work experience
• 2+ years of Experience working with Microsoft Word (creating, editing, saving documents) and Microsoft Excel (creating, editing, saving spreadsheets) and Microsoft Outlook
• Bilingual fluency in English and Spanish
• Experience in long-term care, home health, hospice, public health or assisted living
• Experience working with a PC and windows applications, with the ability to learn other sometimes complex systems
• Ability to work on site at least once a month
• Ability to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm MST). It may be necessary, given the business need, to work occasional overtime or weekends
• Must be 18 years of age OR older

Preferred Qualifications:

• Experience as a case management support staff, a customer service representative in a medical office or health plan, utilization review assistant
• Previous experience in a managed care environment
• Previous experience with the State of Texas STAR+PLUS program or similar programs dealing with SSI and disabled adults
• Knowledge of the Medicare/Medicaid dual population

Telecommuting Requirements:

• Reside within 50 miles of 1145 Westmoreland Drive El Paso, TX 79925
• 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

Soft Skills:

• General business and computer knowledge, medical terminology training, some college course work, experience in health care/insurance environment
• Required for completely satisfactory performance in this job is the ability to operate a computer, word processing software, fax machine, photocopier, and multi-line telephone
• Excellent written and verbal communication skills required
• Customer service skills and phone etiquette are required
• Ability to handle high volume of inbound and outbound calls and perform more than one task at a time in a professional manner
• Experience in electronic charting

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves 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.

#RPO

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