Job Closed
This listing is no longer active.
UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Specialty Navigator
Location
United States
Posted
11 days ago
Salary
$18 - $32 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Specialty Navigator
UnitedHealth Group
Role Description Reporting to and working under the general direction of the Supervisor(s) and Manager of the department, the Specialty Navigator reviews complex referral requests and evaluates and assigns appropriate specialists for the patient. Works with patients and providers to understand services being requested. Interviews patients as needed to obtain full understanding of what information is being requested. Works closely with Specialty Nurses to ensure clinical handoffs are safe and appropriate. Coordinates care both within Reliant and Atrius Health and with external partners. Schedule (FT, 38.75 hours/week): Monday – Friday 8:30am – 5pm EST or 8:00am – 4:30pm EST. If you reside within the state of Massachusetts, you will enjoy the flexibility to telecommute as you take on some tough challenges. Primary Responsibilities: - Reviews referral information from clinicians for pertinent information regarding tests, consultations and procedures. - Verifies demographics and insurance information. - Work is highly complex and detail oriented, involving frequent contact with a range of internal and external contacts as well as the need to understand terms and processes of multiple payers. - Reviews referral information from work queue for pertinent information regarding referral requests. - Reviews each external referral for opportunity to convert to internal referral and reviews options with patients. - Redirect patients with managed care products appropriately ensuring clinical handoff is safe using expertise of specialty nurses. - Ensures adequate information is obtained and relayed when care is moved. - Explains insurance benefits and options to patients. - Explains denials to patients. Keeps patient informed of status of all referrals (approved and denied). - Notifies patients of scheduled appointments and confirms appointments by mail including confirmed location and map of destination. - Informs patients of any preparation that must be completed prior to the appointment. - Contacts patient if insurance coverage issues arise during the referral process so that patient can work directly with the insurance company. - Promotes the Reliant and Atrius Health System of Care by highlighting internal providers and their expertise. - As needed, places orders to start the referral process for the PCP on behalf of patients who have booked appointments and call for the referral. - Researches the visit notes to determine if a referral was intended as well as processing referrals for follow-up or annual visits that require a referral. - Schedules patients for tests, consultations, services and procedures with other departments, local private offices, and/or outside vendors/providers. - Answers phone calls, faxed requests and other inquiries relating to referrals and communicates with the physicians and clinicians to acquire authorization or to inform them of patient issues or clinical paperwork needed. - Researches questions/concerns from patients regarding bills and determines if issue is related to the referral process. - Assists in resolving billing and denied referral matters as they relate to the referral process. - Refers patients to appropriate staff (e.g., patient account representatives) for billing issues related to insurance benefits and services covered under the benefits plan. - Works in collaboration with the person designated as the Practice’s Benefits Coordinator to maintain cost control, ensure that services provided are within benefit plan guidelines, and that necessary policies and procedures are followed when dealing with non-preferred providers/vendors. - May coordinate second opinion requests. - Works with supervisors to ensure patients are receiving timely responses and detailed answers to their complex questions. - Receives escalated issues and stat same day calls; determines appropriate action and/or works with clinical team for decision. - Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed. - Supports roles within the Navigator. - Trains and teaches as needed. - Participates in problem solving activities, focusing on productivity and quality. - Works with supervisors to ensure continuous improvement of the department. - If needed, contacts appropriate parties to obtain referral authorizations and verify coverage (e.g., the Authorization Services Unit (ASU), National Imaging Associates (NIA) or individual insurance companies). - Certain departments may also need to contact additional outside agencies for approval (e.g., American Imaging Management or Med Solutions). Qualifications - High School Diploma/GED. - 1+ years of receptionist, admin support, or healthcare-related experience. - Intermediate level of proficiency with MS Office tools. - Must reside in the state of Massachusetts. Requirements - 1+ years of experience working in a medical front office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays and maintaining medical records. - Previous call center experience. - Proficiency in Microsoft Office (Word, Excel and Outlook). - Ability to learn new software (EPIC/EMR) and flexibility to attend new hire training. - Knowledge of Epic EMR software. Benefits - Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays. - Medical Plan options along with participation in a Health Spending Account or a Health Saving account. - Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage. - 401(k) Savings Plan, Employee Stock Purchase Plan. - Education Reimbursement. - Employee Discounts. - Employee Assistance Program. - Employee Referral Bonus Program. - Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).
Related Guides
Related Categories
Related Job Pages
More Recruitment Jobs
Senior Recruiter – 3 Month Contract
HeadQuartersWe handle the administrative work for some of the biggest Cannabis companies so they can focus on what they do best.
• Manage full-cycle recruitment processes for a variety of roles across operations, customer experience, finance, technology, compliance, and corporate functions. • Partner with hiring managers to understand business needs, define role requirements, and create effective hiring strategies. • Source and attract top talent through LinkedIn, job boards, referrals, networking, and other creative recruiting channels. • Conduct recruiter screenings and coordinate interview processes with internal stakeholders. • Ensure a positive and professional candidate experience throughout all stages of the hiring process. • Maintain and improve recruiting workflows, reporting, and applicant tracking systems. • Build and maintain talent pipelines for current and future hiring needs. • Support onboarding coordination and offer management processes. • Monitor recruiting metrics including time-to-fill, pipeline conversion, and hiring effectiveness. • Stay informed on market trends, compensation benchmarks, and hiring best practices. • Ensure compliance with California employment regulations and internal hiring policies.
Role Description Buscamos Recruiters Freelance con experiencia en procesos de selección, especializados (idealmente) en perfiles técnicos y oficios (electrónica, mecánica, alimentación, etc.), industriales, y mandos intermedios. - Búsqueda de candidatos/as con encaje para las necesidades de nuestros clientes. - Evaluación de sus perfiles a través de entrevistas, realización de informes y presentación de sus candidaturas a nuestros consultores internos. Qualifications - Experiencia previa como recruiter o headhunter (in-house o freelance). - Capacidad para reclutar los mejores candidatos. - Uso de tus propias herramientas de sourcing y seguimiento (Infojobs, Indeed, Linkedin, etc.). - Alta orientación al cliente y al cierre de procesos. - Capacidad para trabajar bajo modalidad freelance o régimen de autónomos. - Residencia en España y poder facturar como autónomo/a o sociedad limitada en España. Benefits - Total independencia: Tú eliges cómo trabajar, con tus propios métodos y herramientas. - Altas comisiones: Obtendrás el 50% de cada proceso de selección. - Clientes sin buscar: Nuestra empresa te proporcionará oportunidades activas con empresas que necesitan talento. - Flexibilidad total: Tú decides cuántos procesos asumir y cuándo. - Modalidad contractual mercantil. Company Description Colaborarás con Reclut, consultora de recruiting & headhunting que trabaja todo tipo perfiles en todos los sectores (industrial, alimentación, agrario, pharma, sanitario, etc.).
Senior Recruiter
HeadquartersHeadQuarters is a global start-up that partners with US cannabis companies to provide support in finance, sales operations, marketing and logistics.
Role Description - Manage full-cycle recruitment processes for a variety of roles across operations, customer experience, finance, technology, compliance, and corporate functions. - Partner with hiring managers to understand business needs, define role requirements, and create effective hiring strategies. - Source and attract top talent through LinkedIn, job boards, referrals, networking, and other creative recruiting channels. - Conduct recruiter screenings and coordinate interview processes with internal stakeholders. - Ensure a positive and professional candidate experience throughout all stages of the hiring process. - Maintain and improve recruiting workflows, reporting, and applicant tracking systems. - Build and maintain talent pipelines for current and future hiring needs. - Support onboarding coordination and offer management processes. - Monitor recruiting metrics including time-to-fill, pipeline conversion, and hiring effectiveness. - Stay informed on market trends, compensation benchmarks, and hiring best practices. - Ensure compliance with California employment regulations and internal hiring policies. Qualifications - 5+ years of full-cycle recruiting experience, preferably in high-growth startups, operations-heavy companies, logistics, retail, or regulated industries. - Bilingual English/Spanish. - Experience recruiting for a wide variety of roles, including both exempt and non-exempt positions. - Strong sourcing and talent acquisition skills using LinkedIn Recruiter and modern recruiting tools. - Excellent communication and stakeholder management abilities. - Ability to manage multiple open positions simultaneously in a fast-paced environment. - Experience with ATS platforms and recruiting analytics/reporting. - Strong organizational skills and attention to detail. - Ability to work independently while collaborating cross-functionally. - Experience in cannabis, e-commerce, delivery, logistics, or startup environments is a plus. Requirements - Experience supporting remote and distributed teams. - Strong sense of urgency and problem-solving mindset.
Talent Acquisition Specialist
EnavateWe transform businesses and the lives they touch. To us, it’s personal.
Role Description The Talent Acquisition Specialist is the owner of the recruiting process. They partner with Hiring Leaders, HR Business Partners, and Interviewers to hire great talent for the company, providing excellent candidate experience. Locations: Kyiv, or remote, Ukraine. Reporting System: reports to a Talent Acquisition Leader. Your day will consist of: - Full cycle recruitment of all assigned positions; - Passive candidate sourcing via resume databases, social media, and other channels; - Prescreening/interviewing of qualified candidates; - Scheduling of interviews with the hiring team, plus facilitation of post-interview feedback; - Develop and cultivate trusting relationships with Hiring Leaders across North America and Eastern Europe; foster collaboration via consistent communication; - Create and execute compelling candidate marketing campaigns to engage passive candidates; - Maintain Applicant Tracking System; - Support and improve the hiring process, candidate experience, and hiring team experience. Qualifications - Fluent in written and spoken English (B2+); - 3+ years of full-cycle recruitment experience; - Experience sourcing passive talent and generating interest via a variety of platforms, including resume databases and LinkedIn; - High attention to detail, excellent communication skills, flexibility to adapt to a rapidly changing environment, and excitement to grow alongside our team. Benefits - Competitive health insurance, wellness programs, and mental health resources; - Flexible working hours and remote work options; - Access to a range of training programs, workshops, and reimbursement for certifications and courses; - Unlimited paid time off (PTO) covering vacation, sick leave, holidays, and personal days; - Team member recognition programs to acknowledge contributions.
