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Telephonic Nurse Advocate, RN - Eden Prairie, MN

UnitedHealth Group

Eden Prairie, MN
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Job Details

Telephonic Nurse Advocate, RN - Eden Prairie, MN(Job Number:723864)

The quality of care we provide our patients doesn't change no matter how it is delivered. Joining UnitedHealthcare as a Call Center Registered Nurse can be your opportunity to offer a higher level of care to our members. While your work will take place over the phone, you'll have a direct impact on the lives of our members, recommending an appropriate level of clinical care and connecting them with the resources they need to make informed health decisions. You'll act as a compass for our members, guiding them through a complex medical environment as you identify appropriate providers and services, act as a health coach and provide referrals in order to optimize health outcomes. This is an exciting time to join a truly inspired organization. Take this opportunity and begin doing your life's best work.(sm)


The role of the Nurse Advocate is to build trusted relationships with members across their health care lifecycle as an RN (with current licensure), beginning with benefits and claims concerns and providing treatment education as appropriate.  This is done by assisting in Benefit Plan selection and enrollment, explaining claims processing, and educating members about management of their health and well-being, and owning administrative customer service inquiries through to resolution. 


This role is heavily customer service oriented, time is roughly split to 30% Clinical Support and 70% Administrative Benefits and Claims Support and resolution. 


Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.

**This is an office-based role for the first year, after 12 months if you are meeting performance metrics you may be able to transition to a telecommuter, however there is no guarantee.**

Primary Responsibilities:

  • Provides white-glove level service, removing burdens and providing end-to-end resolution for members. This includes, but is not limited to: Clinical, Financial Decision Support, Behavioral Support, Claims inquiries, and more
  • Answer up to 50 to 70 incoming calls per day from members of our health / dental / vision / pharmacy plans
  • Resolves escalated complex and repeat calls from members and works directly with business partners (complex claim reconsiderations, notifications, appeal considerations)
  • Monitor and provide proactive support to members with more chronic disease process issues
  • Work with partners including medical, clinical, financial, behavioral and Rx to resolve issues
  • Provide coaching as needed
  • Provide feedback on process improvement
  • Work with supervisors on enhancing performance

Job Call Center/Triage
Primary Location US-MN-Eden Prairie
Other Location 
Organization Optum Ops-PHM Commercl Inbound
Schedule Full-time
Number of Openings 13
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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