Healthcare Referral Specialist

Optum is a global organization dedicated to delivering exceptional care backed by innovative technology, ultimately helping millions of people lead healthier lives. Joining our team means actively contributing to improved health outcomes by connecting individuals with the care, pharmacy benefits, data, and resources they require to thrive. Here, you will experience a culture rooted in diversity and inclusion, work alongside talented peers, and enjoy comprehensive benefits and career development opportunities. Come make a meaningful impact in the communities we serve as we work together to advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Healthcare Referral Specialist plays a vital role in processing referrals from Primary Care Providers, both internal and external, to facilitate access to specialist care through our network of providers.

In this role, you will build, submit, process, and schedule referrals from primary care providers to ensure patients receive the necessary specialty care. Your responsibilities will include verifying that all required documents and information are provided, requesting additional information when needed, canceling referrals that do not meet criteria or lack necessary information, and directing questionable cases for MD review. You will determine if referrals qualify for outsourcing or overflow. Despite primarily being a computer-based position, this role involves significant paperwork handling, phone communication, and interaction with patients.

Schedule: Monday to Friday from 8:00 am to 5:00 pm.

Location: 2716 Tennaya Drive, Las Vegas, NV 89128.

Primary Responsibilities:

• Building new referrals from network providers.
• Ensuring all necessary documents and information are present.
• Requesting additional information as needed.
• Cancelling referrals that do not meet criteria or lack required information, and forwarding questionable cases for MD review.
• Accepting referrals and assessing eligibility for outsource or overflow services.
• Managing substantial paperwork, including faxing and scanning, while also making multiple telephone calls.
• This role is primarily sedentary, with over 90% of time spent on a computer and communicating via telephone.
• Performing all other duties as assigned.

Why consider a career with UnitedHealth Group? Our competitive base pay, comprehensive benefits program, performance rewards, and a committed management team dedicated to your success set us apart. Some of our offerings include:

• Paid Time Off starting from your first pay period, in addition to 8 Paid Holidays.
• Medical Plan options along with participation in a Health Spending Account or Health Savings Account.
• Dental, Vision, Life & AD&D Insurance along with Short-term and Long-term Disability coverage.
• 401(k) Savings Plan and Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts and assistance programs.
• Employee Referral Bonus Program.
• Voluntary Benefits (e.g., pet insurance, legal insurance, long-term care insurance).

You will be rewarded and recognized for your achievements in a supportive environment that challenges you and provides clear guidance for success in your current role and potential future roles.

Required Qualifications:

• High School Diploma/GED (or higher).
• CPR certified or able to obtain certification within 30 days of employment.
• 2+ years of experience in a health-related field.
• 2+ years of experience with Electronic Medical Records (EMR) and/or Practice Management Software systems.

Preferred Qualifications:

• 1+ year of experience and/or training as a Medical Assistant.
• Bilingual in English and Spanish.

Soft Skills:

• Excellent communication skills and phone etiquette.

Compensation for this role will range from $17.74 to $31.63 per hour, depending on various factors including local labor markets, education, work experience, certifications, and more. We comply with all minimum wage laws and offer a wide array of benefits and incentives.

At UnitedHealth Group, we are committed to helping people live healthier lives and creating a health system that works better for everyone. We believe everyone, regardless of their background, deserves the opportunity to achieve their healthiest life. We recognize that there are significant barriers to good health, particularly for people of color and historically marginalized groups, and we are dedicated to addressing these disparities through equitable care and improving health outcomes.

UnitedHealth Group is an Equal Employment Opportunity employer and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws. Furthermore, UnitedHealth Group is a drug-free workplace, and candidates are required to pass a drug test before starting employment.