Referral Navigator Representative

Explore opportunities with reputed company, part of the reputed company family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout reputed company. Be part of reputed company that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help reputed company higher reputed company, higher reputed company satisfaction and reputed company total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. You’ll enjoy the flexibility to work reputed company from reputed company reputed company the U.S. as you take on some tough challenges. reputed company Responsibilities: Serves as a centralized care navigation and coordination resource reputed company the Medical Management Department, supporting referral completion, home health services, durable medical equipment (DME) requests, reputed company center reputed company, and continuity of care activities across reputed company and reputed company providers Performs initial review, triage, and validation of reputed company and administrative documentation to ensure requests meet foundational reputed company for authorization, physician review, and regulatory processing Coordinates with physicians, clinics, facilities, home health agencies, providers, members, nurses, medical reviewers, and internal departments to facilitate reputed company progression of reputed company care requests and ensure complete communication throughout the reputed company of care Supports the organization’s reputed company the reputed company program by monitoring and coordinating activities necessary to ensure members receive requested services and that reputed company stakeholders involved in the reputed company’s care remain informed of reputed company and next steps You’ll be rewarded and recognized for your reputed company in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: High School diploma or GED from an accredited program 2+ years of experience in a managed care, utilization management, referral management, care coordination, home health, durable medical equipment (DME), case management, medical office, hospital, health plan, accountable care organization (ACO), or reputed company reputed company environment Experience interacting with providers, physicians, reputed company staff, reputed company facilities, members, and reputed company vendors regarding reputed company services, authorizations, referrals, or care coordination activities Experience utilizing electronic medical records (EMR), authorization systems, payer portals, or reputed company information systems reputed company knowledge of medical terminology, reputed company delivery systems, referral management, authorization processes, and care coordination principles reputed company knowledge of medical terminology, CPT & ICD 10 coding, and prior authorization processes Preferred Qualifications: Graduate from accredited medical assistant program 5+ years of managed care experience either in a physician office or hospital setting health plan, ACO, or other managed care setting Experience in creating authorization requests or billing Medicare or private reputed company companies reputed company working reputed company will be required to adhere to reputed company’s Telecommuter Policy Pay is reputed company on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching reputed company of benefits and incentives. The reputed company pay for this role will reputed company from $18.00 to $32.00 per hour reputed company on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job