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Optum

Plan Advisor Representative

Posted 5 Hours Ago
Be an Early Applicant
In-Office
Las Vegas, NV
18-32 Hourly
Junior
In-Office
Las Vegas, NV
18-32 Hourly
Junior
Provide onsite customer service as the Plan Advisor for a client: resolve benefits, eligibility, claims and spending account inquiries; research complex issues across systems; educate members on plan features and preventive care; document interactions and follow through to resolution; escalate when needed and assist members with provider interactions and appointment scheduling.
The summary above was generated by AI
Requisition Number: 2351953
This position is Onsite. Our office is located at 3355 Las Vegas Boulevard S, Las Vegas, NV 89109.
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.
In this role you will be the onsite Plan Advisor for an essential client. You will work directly with the clients Human Resources and Benefits team, acting as the face of the organization and delivering exceptional service. The training will be virtually conducted remotely, after training this position will be onsite.
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 7am - 4pm PST. 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. 100% attendance during training is mandatory. Training will be conducted virtually.
Primary 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
  • Document interactions and follow through to resolution
  • 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 customer 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

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 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 interact with members onsite and follow up with approximately 50-100 members per month and requires full attention to work duties.
  • Training is 13 weeks and will be conducted virtually, during this period you must have: Ability to keep all company sensitive documents secure (if applicable), a dedicated work area established that is separated from other living areas and provides information privacy and high speed internet access
  • This position is full-time onsite, you must work full time at: 3355 Las Vegas Boulevard S, Las Vegas, NV 89109
  • Ability to work 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 7am - 4pm PST. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:
  • Experience with utilizing multiple systems / platforms while on a call with a member
  • Current or previous work within UMR
  • Familiarity with medical OR dental terminology, health plan documents, OR benefit plan design

Soft Skills:
  • 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

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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 - $32.12 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.
#RPO #RED

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