Plan Advisor Representative

This position is national remote, offering the flexibility to telecommute from anywhere within the U.S. as you take on challenging and rewarding work. UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. By joining UMR, you’ll contribute to consumer-oriented health benefit plans for millions, focusing on higher quality care, lower costs, and greater access to healthcare. This role provides opportunities for career development and advancement due to UMR’s record-breaking growth.

About the Role

This is a full-time position (40 hours/week), Monday through Friday. Employees must have flexibility to work any 8-hour shift during normal business hours of 7:00 AM - 7:00 PM CST, with occasional overtime as needed. The role includes 13 weeks of paid training (depending on business needs), conducted virtually from 8:00 AM - 4:30 PM CST, Monday through Friday. Within 6-8 months after initial training, an additional 5 weeks of training will be required. 100% attendance during training is mandatory.

Responsibilities

• Provide an exceptional customer service experience by responding to and resolving inquiries related to benefits, eligibility, claims, financial spending accounts, and correspondence.
• Research complex issues (e.g., medical, dental, flex spending, pharmacy) across multiple databases and collaborate with support resources to resolve customer issues.
• Own issues through to resolution in real time or via comprehensive follow-up with the member.
• Apply creative solutions and problem-solving techniques to address members' needs.
• Educate members on health incentives offered by their employer, as well as consumer-driven health products such as HSAs, HRAs, and HDHPs.
• Educate callers on the benefits of a primary care physician and ensure preventive screenings are completed.
• Intervene with care providers (e.g., doctor’s offices) on behalf of members to assist with appointment scheduling or other matters.
• Address complex issues and escalate complicated situations to appropriate departments or leadership when necessary.
• Translate healthcare-related terminology and complex processes into simple, step-by-step instructions for members.

Requirements

• High School Diploma/GED or 10+ years of equivalent work experience.
• Must be 18 years of age or older.
• 1+ years of customer service experience in an office or professional setting.
• Capability to handle 50-70 calls daily while maintaining full attention to work duties (uninterrupted work time required outside of scheduled breaks).
• Ability to participate in training and demonstrate understanding of material, with or without reasonable accommodation.
• Flexibility to work any full-time (40 hours/week) 8-hour shift during business hours (7:00 AM - 7:00 PM CST), Monday through Friday, with occasional overtime as needed.

Preferred Qualifications

• Familiarity with medical or dental terminology, health plan documents, or benefit plan design.
• Experience using multiple systems/platforms while on a call with a member.

Telecommuting Requirements

• Ability to keep company-sensitive documents secure.
• Dedicated work area separated from other living areas, ensuring information privacy.
• Must live in a location with a UnitedHealth Group-approved high-speed internet connection (wired connection required: cable, DSL, or fiber with minimum speeds of 25 Mb download/10-15 Mb upload). Wireless services such as satellite, hotspot, or line-of-sight antenna are not permitted.

Skills

• Strong computer and Windows PC skills, including keyboard navigation and learning new programs.
• Ability to build rapport quickly and respond to customers compassionately by identifying and exceeding their expectations.
• Active listening skills to gather relevant information, determine immediate requests, and identify member needs.
• Flexibility to adapt communication style to meet diverse member personalities and needs.
• Proficient problem-solving skills to assess situations and formulate recommendations.
• Strong conflict management skills, including resilience in stressful situations.
• Ability to manage multiple tasks and comprehend various products and benefit levels.

Pay

The salary for this role ranges from $18 - $32 hourly based on full-time employment, depending on factors such as local labor markets, education, work experience, and certifications.

Benefits

• Comprehensive benefits package (subject to eligibility requirements).
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.

Schedule

• Full-time (40 hours/week), Monday through Friday.
• Shift flexibility required within business hours of 7:00 AM - 7:00 PM CST.
• Occasional overtime may be necessary based on business needs.
• 13 weeks of paid training (8:00 AM - 4:30 PM CST, Monday through Friday), with 100% attendance mandatory.
• Additional 5 weeks of training within 6-8 months after initial training.