1+ months

Optum Healthcare Advisor - Atlanta, GA

Atlanta, GA 30303
  • Job Code
    891361

Our Optum Health Care Advisor role is challenging, rewarding, and allows for individual growth and the chance to focus on a variety of skills.  Are you ready to make heath care work better?


An Optum Health Care Advisor (OHCA) is a single point of contact for consumers for all things related to  health and wellness benefits. A Health Care Advisor helps members navigate the health care system; including helping with claim and benefits questions, helping members find quality doctors and schedule appointments; connecting consumers with health and wellness resources; and coaching members to make better health choices by providing education. A Health Care Advisor creates an ongoing and lasting impression of the Optum consumer experience.


This position is full-time (40 hours/week) Monday- Saturday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (6:50am - 10:00pm Monday-Friday and 8:00am-4:30pm Saturday). It may be necessary, given the business need, to work occasional overtime. Our office is located at 2100 Riveredge Parkway, Atlanta, GA.  You must be able to work in our office.  This is not a remote position

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There are several steps in our hiring process. Please make sure that you have filled out all required sections of your employment application. Once you submit your completed application, you will receive an email with information regarding next steps including any pre-employment assessment(s) that are required.  Both your application and any required assessment(s) need to be completed before we can consider you for employment so the sooner you complete these two steps, the sooner you will hear from us. To learn more, go to: http://uhg.hr/OurApplicationProcess


Primary Responsibilities:

  • Handle inbound and outbound calls with an emphasis on excellent customer service in a call center environment.
  • Take responsibility for addressing member issues, questions, concerns, and see them through to resolution.
  • Respond to members and providers in a polite and courteous manner, with patience, empathy, care, compassion, and sincerity in voice tone and pace.
  • Assist members with medical and pharmacy benefits, medical plan overview, behavioral health inquiries, claims, provider search and prior authorization.
  • Provide member education on HSA, FSA, HRA, and other financial accounts.  
  • Serve as a Health Care Advisor, going above and beyond for consumers, creating a memorable consumer experience, and providing expert, proactive service to members by:
    • Finding creative ways to do more than what the member expects
    • Delighting each member by meeting their unexpressed needs
    • Leaving each person feeling confident and cared for 
  •  Provide services such as:
    • Education to help simplify the healthcare system and validate members understanding of  next best actions
    • Advise members in choosing healthcare providers that meet and exceed consumer needs
    • Educate members on clinical and wellness resources they can take advantage of to manage a health condition/disease or reach a wellness goal
    • Provide education to members to assist in understanding benefits, terminology, claim resolution and Explanation of Benefit interpretation
    • Serve as an advocate by responding to, resolving and escalating complex claim issues with internal and external resources
    • Initiate telephone calls to internal sources, membership, providers, and other claim payers to gather data and determine resolution to claim issues
    • Refer qualified members into Wellness and clinical programs
    • Solve problems systematically, using sound business judgment, and following through on commitments 
  • Consistently meet established productivity, schedule adherence, meeting metric expectations, and quality audit standards
  • Work with cross carries to ensure member follow up and resolution (cross carrier functions)
  • Work with providers and plans to help ensure critical info is being relayed timely between the plan and the provider.
  • Support multiple clients and their individual expectations.
  • Help establish patient appointments for the first time visit to the PCP.
  • Provide community resources once internal resources have been exhausted (e.g. Financial assistant programs, Medical assistant program resources)
  • Work with Network management to ensure panel request are up to date and when providers are not confirming to the contract (e.g.balance billing)

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.

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Posted: 2020-09-18 Expires: 2020-11-12

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Optum Healthcare Advisor - Atlanta, GA

UnitedHealth Group
Atlanta, GA 30303

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