Specialty Navigator I at UnitedHealth Group
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Specialty Navigator I
Norwood Massachusetts
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Caring. Connecting. Growing together.
With these values to guide us our people are committed to making a meaningful difference in the lives of those we are honored to serve.
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Specialty Navigator I
Requisition number 2339107
Job category Medical & Clinical Operations
Primary location Norwood MA
Date posted 03172026
Overtime status Non-exempt
Travel No
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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.
Reporting to and working under the general direction of the Supervisors and Manager of the department the Specialty Navigator I process referrals and authorizations for Atrius Health patients. Receives inbound requests calls emails faxes etc. as well as from within the work queues. Maintains patient records and continually provides information to patients and specialists.
Schedule
FT 40 hours. Monday - Friday 830am - 5pm.
This is a hybrid role - hybrid schedule to be determined by manager upon hire.
Location
1177 BOSTON PROVIDENCE HWY NORWOOD MA 02062
If you live near NORWOOD MA you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.
Primary Responsibilities
Manage the referral process processing incoming and outgoing referrals and prior authorizations including intake notification and census roles
Handle resolution inquiries from members and/or providers. This is high volume customer service environment. Youll need to be efficient productive and thoroughly dealing with our members over the phone
Answers and replies to a large volume of telephone calls faxes and internet queries utilizing and adhering to department scripts and guidelines
Reviews patient record. If referral does not already exist obtain authorization from payer enter information into EPIC. Forwards authorization to specialists office
Keeps patient and facility informed of status referrals updates and process
Obtains authorization from payer websites efficiently and effectively. Keeps log in and credentials
Research questions and concerns from patients assists in resolving any issues as they relate to the referral process
Escalates difficult issues problems etc. to higher level coordinators or supervisory staff
Works with team to ensure timely process of referrals. Participates in team problem solving activities focusing on production and quality
Customer Service
Ability to provide a high level of customer service to patients visitors staff and external customers in a professional service-oriented respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations
Written Communications
Ability to summarize and communicate in English moderately complex information in varies written formats to internal and external customers
Oral Communications
Ability to comprehend and communicate complex verbal information in English to medical center staff patients families and external customers
Teamwork
Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas identifying issues and respecting team members
Accesses only the minimum necessary protected health information PHI for the performance of job duties. Actively protects the confidentiality and privacy of all protected health information they access in all its forms written verbal and electronic etc. taking reasonable precautions to prohibit unauthorized access. Comply with all Atrius Health and departmental privacy policies procedures and protocols. Follows HIPAA privacy guidelines without deviation when handling protected health information
Performs other duties as assigned
What are the reasons to consider working for UnitedHealth Group Put it all together - competitive base pay a full and comprehensive benefit program performance rewards and a management team who demonstrates their commitment to your success. Some of our offerings include
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
401k 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.
Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 higher
1 years of customer service experience preferably in a healthcare setting
Intermediate level of proficiency with creating editing saving and sending documents utilizing Microsoft Word and Excel
Intermediate level of proficiency with typing and talking at the same time and navigating through multiple screens
Preferred Qualifications
Experience working within the healthcare industry and with healthcare insurance
Experience working in a metric-driven work environment
Call center experience
A clerical or administrative support background
Knowledge of ICD-9 and CPT codes
Soft Skills
Independence of Action Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seek assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager
Knowledge Ability to demonstrate full working knowledge of standard concepts practices procedures and policies with the ability to use them in varied situations
All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.
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
UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.
What we do
Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.
https://www.youtube.com/watch?v=5PbNyi2IDkY
Caring. Connecting. Growing together.
Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:
• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. Learn more about what we offer.
• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. Learn more about our culture.
• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. Discover all the ways you can learn, grow and develop.