Prior Authorizations Analyst - Worcester, MA

If you are in Worcester, MA, you will have the flexibility to work from home and the office in this hybrid role as you take on some tough challenges.

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

This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 4:30pm EST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 100 FRONT STREET Worcester, MA 01606.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:

• Contacts patients for the purpose of achieving established outreach program goals. This may include contacting patients via telephone, email and/or direct mailings to stress the clinical importance of receiving their recommended lab work and attending their medical appointments
• At the request of a Clinician, may place lab order and/or schedule appointments in electronic medical record system
• Generates reports using Healthy Planet Registry in Epic EMR to identify patients who require additional labs to be ordered as well as identifying patients who are over-due for labs
• Consults with clinicians to determine required population reports and/or patient lists for analysis and outreach
• Communicates and collaborates with care coordination staff to optimize patient care, and supports patient care plans by assisting with linkages to, coordination of, and monitoring identified service needs
• Recognizes and reports data inconsistencies, gaps in performance, and opportunities to improve results to appropriate personnel

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
• 18 years or older
• Ability to work full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 4:30pm EST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Microsoft Office Suites
• 1+ years experience in healthcare
• Proficient with data manipulation including the ability to develop spreadsheets, build data tables and extract data
• Proficiency with electronic medical record systems
• Knowledge and understanding of medical terminology
• Ability to travel up to 100% of the time

Telecommuting Requirements:

• Reside within commutable distance of 100 FRONT STREET Worcester, MA 01606.
• 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.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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