Optum
Enrollment Analyst II - Kelsey Seybold Clinic - Pearland Business Office
Be an Early Applicant
Manage and process KelseyCare Advantage enrollment applications, resolve eligibility issues, update member records for 100,000+ members, support data file processing, communicate with members/clinics/plans, mentor Level I analysts, and assist with system testing and data integrity.
Requisition Number: 2368373
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
This role involves managing and processing enrollment applications for KelseyCare Advantage across different health plan options. It includes handling calls from members, clinics, or health plan reps to sort out any eligibility queries, as well as making calls to confirm members' enrollment status. The job requires analyzing eligibility documents, using a variety of system applications and databases to process files, addressing eligibility edits, and keeping the enrollment system data updated for over 100,000+ managed care members. As a go-to person for initial level escalated eligibility issues, this position also offers guidance and expertise to level I Enrollment Analysts. Additionally, the role covers updating member eligibility, supporting the processing of data files from employer group health plans, managing enrollments, handling necessary member communications, and helping with system testing.
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:
Preferred Qualifications:
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 requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare is an Equal Employment Opportunity employer under applicable law 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, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
This role involves managing and processing enrollment applications for KelseyCare Advantage across different health plan options. It includes handling calls from members, clinics, or health plan reps to sort out any eligibility queries, as well as making calls to confirm members' enrollment status. The job requires analyzing eligibility documents, using a variety of system applications and databases to process files, addressing eligibility edits, and keeping the enrollment system data updated for over 100,000+ managed care members. As a go-to person for initial level escalated eligibility issues, this position also offers guidance and expertise to level I Enrollment Analysts. Additionally, the role covers updating member eligibility, supporting the processing of data files from employer group health plans, managing enrollments, handling necessary member communications, and helping with system testing.
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 or equivalent
- 3+ years of experience in eligibility/enrollment within the managed care industry
- Proficient in Microsoft Office Suite, including Access, Excel, Word, and Outlook
- Excellent written and verbal communication skills
- Proven ability to read and interpret technical reports
- Proven ability to analyze and interpret data using Microsoft Excel and Access and provide feedback to appropriate personnel
- Proven to be flexible; able to work independently or in a team environment; able to work overtime as needed
- Proven to be detailed and able to work with minimum supervision to meet strict deadlines
Preferred Qualifications:
- Some college or technical school
- Prior experience in customer service in healthcare Industry
- Prior experience with Medicare Advantage
- Working knowledge of Epic Tapestry system
- Working knowledge of TriZetto Enrollment Administration Manager (EAM) application
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 requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare is an Equal Employment Opportunity employer under applicable law 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, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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