Plan Advisor Representative

About the position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. UMR, UnitedHealthcare’s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It's that simple . . . and it's that rewarding. In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth. Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career. 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 7:00 AM - 7:00 PM CST. It may be necessary, given the business need, to work occasional overtime. We offer 13 weeks of paid training (depending on business needs). The hours during training will be 8:00 AM - 4:30 PM CST from Monday - Friday. Within 6 - 8 months after the initial training, you will attend an additional 5 weeks of training. 100%25 attendance during training is mandatory. Training will be conducted virtually from your home. 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.

Responsibilities

  • Provide an exceptional customer service experience when responding to and resolving customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts, and correspondence
  • Research complex issues (such as Medical, Dental, Flex Spending, Pharmacy, etc.) across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
  • Own issue through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
  • Apply creative solutions and effective problem solving techniques to address members’ needs
  • Educate the member on health incentives offered by their employer as well as consumer driven health products; HSA, HRA, and HDHP - some resulting in additional healthcare dollars for the member to utilize
  • Educate the caller on the benefits of a primary care physician and help to ensure / educate that all preventive screenings have been completed
  • Intervene with care providers (doctor’s offices) on behalf of the member to assist with appointment scheduling or other matters when needed
  • Address complex issues with an awareness of when to refer complicated situations to various departments or leadership for further assistance
  • Translate healthcare - related terms or terminology and complex processes into simple, step - by - step instructions which members can understand

Requirements

  • High School Diploma / GED OR 10+ years of equivalent work experience
  • Must be 18 years of age OR older
  • 1+ years of customer service experience in an office OR professional setting
  • This position will receive member calls up to 50 - 70 calls daily and requires full attention to work duties. Employees in this role must ensure they will have uninterrupted work time while they are on shift (outside of normally scheduled breaks and lunch).
  • Capability to participate in training classes and demonstrate understanding of the material, with OR without reasonable accommodation
  • Ability to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 7:00 AM - 7:00 PM CST from Monday - Friday. It may be necessary, given the business need, to work occasional / voluntary overtime.
  • 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.
  • Experience using a computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
  • Capability to quickly build rapport and respond to customers compassionately by identifying and exceeding their expectations (responding respectfully, timely, and consistently meeting commitments), with or without reasonable accommodations
  • Capability to listen skillfully, gather relevant information, determine immediate requests, and identify the current and future needs of the member, with or without reasonable accommodations
  • Flexibility to customize approach to meet all types of member communication styles and personalities
  • Proficient problem solving approach to quickly assess current state and formulate recommendations
  • Proficient conflict management skills, including the capability to resolve issues in stressful situations and demonstrate personal resilience, with or without reasonable accommodations
  • Capability to manage multiple tasks and comprehend various products and their respective benefit levels, with or without reasonable accommodations
  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice-to-haves

  • Familiarity with medical OR dental terminology, health plan documents, OR benefit plan design
  • Experience with utilizing multiple systems / platforms while on a call with a member

Benefits

  • a comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
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