Financial Navigator - Worcester, MA
: Job Details :

$3000 Sign-On Bonus for External Candidates

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.

Focuses on treating and preventing financial toxicity by guiding patients through our complex healthcare system to help them gain access to care by reducing financial barriers. Provides evaluation and coordination of patient assistance programs, coordination, and scheduling of patients for financial interviews and financial counseling. Interfaces with insurance plans for benefit limits and patient's estimated out of pocket expense. Serves as a liaison related to patient billing disputes; charity care applications and eligibility; and departmental policies and procedures. Works closing with billing team to ensure timely claim and account follow - up for patient assistance sources.

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 AM - 4:30 PM or 5:00 PM. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home.

We offer 12 - 16 weeks of paid training. The hours of the training will be based on your schedule or will be discussed on your first day of employment. Training will be conducted onsite.

If you are within commutable distance to the office at 5 Neponset Street, 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.

Primary Responsibilities:

• Has an understanding of the care of the cancer patient, including treatment plans.
• Review patient chemotherapy protocols and determine insurance benefits and patient responsibility.
• Verify eligibility and benefits for all new patients and existing patients receiving treatment.
• Has a strong knowledge of healthcare insurance guidelines, programs and plans, patient assistance programs, co-pay assistance programs, Medicare health plans, Medicaid plans, COBRA guidelines and Healthcare reform.
• Works with patients to help understand and optimize their health insurance and supplemental coverage options for medical and pharmacy benefits.
• Verifies current insurance coverage, including out - of - pocket costs, deductibles, and / or coinsurance as necessary.
• Assist patients with insurance questions.
• Assess patient need for outside assistance with medical care payments and if so, what programs might be available for individual patients, i.e., pharmaceutical, copay assistance, etc.
• Assists patients with enrolling in Medicaid and other government - sponsored healthcare assistance programs.
• Acts as the patient's direct primary point of contact for all insurance and billing inquiries.
• Possess strong research and problem - solving skills.
• Demonstrates a high level of initiative and ability to self-direct to solve financial problems of patients.
• May need to work collaboratively with the cancer team to adjust care accordingly.
• Properly document appropriate information in the Patient EMR.
• Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
• Complies with established departmental policies, procedures, and objectives.
• Enhances professional growth and development through educational programs, seminars, etc.
• Attends a variety of meetings, conferences, and seminars as required or directed.
• Performs other similar and related duties as required or directed.
• Regular, reliable and predicable attendance is required.

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
• Must be 18 years of age OR older
• 3+ years of relevant work experience with healthcare insurance background (for example: medical insurance, pharmacy insurance, OR co - pay and deductibles)
• Knowledge of various software applications such as Microsoft Word, Microsoft Excel, Microsoft Outlook, etc.
• Ability to work on site and at home in a hybrid setup
• Ability to work any full time shift during our normal business hours of 8:00 AM - 4:30 PM or 5:00 PM from Monday - Friday. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 5+ years of experience with applied knowledge of medical insurance, pharmacy insurance, co - pay and deductibles, patient assistance programs, and grant programs
• Patient assistance programs and grant programs

Telecommuting Requirements:

• Reside within commutable distance to the office at 5 Neponset Street, Worcester, MA
• 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

Soft Skills:

• Excellent interpersonal, communication, organizational, and problem - solving skills.
• Ability to compassionately work with patients who are often frustrated and / or overwhelmed by medical cost.
• Ability to effectively work with physicians, medical staff, and patients.
• Ability to multi - task and prioritize tasks.

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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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