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Special Needs Family Advisor C & S - Pennsylvania Telecommute

Posted on Dec 9, 2018 by UnitedHealth Group

Philadelphia, PA 19113
Health Care
Immediate Start
Annual Salary
We dedicate an elite team of Advisors to serve our United Healthcare Families of Children with Special Needs because we recognize that the health care system needs to be tailored to work for every individual and family to best serve their specific needs. When you join us as an Advisor, you'll have the opportunity to deliver an extraordinary experience to families who need an ally; someone in their corner that is empowered to fast track resolving issues and serves as an ongoing resource to provide guidance and community resources during key transition times in each family's journey. Some issues you will help families resolve include complex benefit, claims and billing issues, prior authorizations, appeals and more.

You will serve these families directly, and you will also have the opportunity to help shape what this elite team does and will evolve to do in order to truly deliver an exceptional experience to these families.
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 life's best work.

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 within a call center setting.

o 9am - 6pm Central Time
o 8am - 5pm Eastern time
o 7am - 4pm Pacific Time

Primary Responsibilities:
  • Provide holistic family support to families of children with special needs, owning end - to - end resolution of benefit issues
  • Serves as an ongoing, single point of contact for members, primarily via the phone channel (may also will use email, chat, text), delivering compassionate support to consumers, creating a memorable, positive consumer experience. Must create and build ongoing relationships with others (to include both consumers and teammates).
  • Make decisions independently and solve problems creatively without requiring established procedures, using sound judgment and critical thinking, while consistently following through on commitments and framing realistic expectations for consumers.
  • Plans, prioritizes, organizes and completes work to meet established objectives.
  • Mentors and coaches' colleagues, and acts as a resource for others.
  • Anticipates member needs and proactively seeks out external and internal resources where appropriate to add unexpected value for the member. Ability to determine appropriate referrals to other programs / services as needed without technology guidance.
  • Provide services such as:
  • Ability to research and provide end to end resolution of coordination of benefits, and medical & pharmacy claims, billing / appeals / prior authorization / etc. issues; striving to remove the burden from the consumer
  • Help members with medical, behavioral and pharmacy needs as well as connect them with resources in and out of our company.
  • Educate and coach consumers on clinical, wellness and community resources they can use to help increase their family's quality of life
  • Educate consumers on their benefit package and quarterback interactions to additional benefit experts or resources.
  • Expected to do much more legwork on the member's behalf and not transfer.
  • Assist consumers in navigating and other UnitedHealth Group resources and encourage and educate them to become self - sufficient
  • Provide resources and guidance to help members navigate key transition times in their dependents' life, when benefits and resources typically change
  • Proactively identifies areas of improvement for the broader member experience and escalates the issue and proposed solution for the benefit of the entire team.
  • Ongoing education for conditions that fall under the special needs umbrella is required. Will be on the job and provided by UHG.
  • Provide other services in the future yet to be defined. For example: decision support services.
To succeed as a Special Needs Service Advocate, ideal candidates will possess:
  • Be passionate about helping individuals and families of children with special needs.
  • Strong empathy, compassion and listening skills
  • Aptitude to be proactive, resourceful and relentless with solving issues and providing support; can think outside the box
  • Have critical thinking and problem - solving skills
  • Be a self - starter and thrives in ambiguity without established processes. Adaptable and driven to improve process.
  • Have strong 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. Able to diffuse consumer distress and manage complex situations as well as prioritize actions, excellent writing skills, and the aptitude to translate complex benefit terminology and processes into common language consumers can understand and act upon
  • Have strong organizational skills in an effort to prioritize tasks effectively and efficiently
  • Work well on a team
  • Must be willing to stay abreast of current special needs services trends for proper delivery of services
  • The ability to be laser - focused on putting consumers' needs at the center of decisions
  • Aptitude to translate complex benefit terminology and processes into common language consumers can understand and act upon
  • Flexibility to continuously evolve the role and try new things
  • Agility in order to excel in a very fast - paced work environment with constant learning and change
Required Qualifications:
  • High School Diploma / GED or higher
  • 2+ years experience in the following: (1) in a consumer - facing role resolving and / or advocating on behalf of consumers; and, (2) in direct education and / or coaching with individuals for health promotion and behavioral change
  • Proficiency using computer and Windows PC applications (Excel, Word and Outlook) - Save, copy and paste.
  • Knowledge in the Community & State line of business is required
  • Proficiency using C & S FACETS, Macess, ICUE and Community Care including: strong keyboard and navigation skills. The ability to type and talk at the same time and toggle between multiple screens
  • Must be able to work within the required hours of this position
  • Candidates must reside in Pennsylvania
  • Experience providing care for children with special needs
  • Claims processing experience
  • Experience within a consumer - 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)
  • Bachelor's Degree or higher in a Social Science field
  • Bilingual (e.g. English / Spanish)
  • 1+ years of experience working in healthcare
Careers with UnitedHealthcare . Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

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.

Keywords: UHG, Telecommute, A4Me, Advocate4Me, Healthcare, Health Advisor, SPECIALNEEDS

Reference: 599332940