Complex Customer Care Representative Senior

Complex Customer Service Representative Senior

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

Patient Experience Department supports creating a complete and positive service experience from enrollment, through all touch points within system as well as any escalated service recovery. Complex Customer Service Representative Senior will function as a support department for the Mountain West and local care delivery system in the following areas; patient service resolution, complaint management, patient feedback, and Burke survey data distribution. Complex Customer Service Representative Senior will support patient experience improvement efforts that align with company's consumer experience initiatives. All members of the Patient Experience team will maintain professional, helpful behavior and language according to company policies and procedures.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime or at weekends.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

• Complex Customer Care Rep Sr is responsible for collaboration with all OptumCare Mountain West departments and IPA offices to ensure the best possible patient experience
• This role focuses on proactive: best practices, consultation and improvement, and other assigned initiatives/projects and reactive job duties: complaint management and resolution
• Manages all patient issues and concerns via dedicated service resolution line (702) 242-HELP line with a compassionate and helpful demeanor delivering White Glove service to all stakeholders
• Assist will receive all messages via the Patient Experience inbox, providing assistance for employees and departments, including but not limited to; UHC Sales Team, member services, scheduling, clinic management
• Complex Customer Care Rep Sr serves as a liaison between customers, patients and / or their families and SMA / OptumCare Mountain West region (i.e., sales, support, clinical departments, and administration) and provides insight and information as it relates to both improvement and complaint management processes
• Provide compassionate patient centric escalated service recovery and complaint resolution for all OptumCare - Mountain West patients
• Creates reports and share metrics, which may include complaint, patient satisfaction, CAHPS/HOS and other quantitative and qualitative data
• Facilitates patient and / or family meetings and helps managers and providers navigate the complaint management process seeking service resolution and patient satisfaction
• Investigates and documents the patient's concerns in a timely manner, and works with clinical and support staff to coordinate a prompt response to the patient and stakeholders
• Assist all the patient issues identified by patient outreach, surveys, and or transfers to senior population within the Nevada, Arizona, and Utah market. Assist patients that may be contacted once per calendar year prior/concurrent to the CAHPS/HOS surveying period
• Accurately track and document all patient issues in Salesforce, report and identify reoccurring service issues and assist with root cause analysis and data in creating strategic planning
• Multi-departmental collaboration with Risk Management, Consumer Affairs, Office of Compliance and Legal Department to resolve issues that may involve Risk to the organization
• Compiles, analyzes and interprets findings/trends for further review by institutional leadership in order to forecast process and service improvement initiatives
• Complex Customer Care Rep Sr must function objectively in sensitive and stressful situation, while maintaining a helpful, collaborative, and positive attitude
• Complex Customer Care Rep Sr must be self-motivated and accountable for meeting expected deadlines and service level agreements, for all reporting tools and our 242-HELP line
• Complex Customer Care Rep Sr must work autonomously, 'think on one's feet', anticipate patient needs, improvise, and synthesize extensive information to focus and resolve the issue meeting our service level agreements
• Complex Customer Care Rep Sr. are responsible for developing and managing cooperative and respectful business relationships that will enhance services available to patients and guests including current physicians, clinic and hospital staff relationships to ensure an optimal patient experience
• Complex Customer Care Rep Sr are responsible for contributing to the creation of and editing of C-I-CARE training material and supporting documentation
• Complex Customer Care Rep Sr re expected to role model the OptumCare C-I-CARE service standards with all colleagues, patients and staff of other departments as a positive representation of the patient Experience Department
• Assist with special projects and/or activities as requested by SVP and VP of Patient Experience or other leadership staff
• Other duties as assigned

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
• Must be 18 years of age OR older
• 3+ years of experience in healthcare, customer service or patient experience-related field
• Experience with Computers and Windows based programs
• Ability to work on-site. Our office is located at 2720 N Tenaya Way, Las Vegas, NV 89128
• Available to work during our normal business hours of 8:00am - 5:00pm PST, Monday - Friday. It may be necessary, given the business need, to work occasionally overtime or weekends

Preferred Qualifications:

• Experience handling escalated calls

Soft skills:

• Excellent written and verbal communication skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20 - $36 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.