OptumTM contact center services

Engagement with the consumer doesn’t end at enrollment. OptumTM contact center specialists engage with members throughout the life of their health plan to help them make the most of their benefits and make better, more informed health care decisions.

Optum contact centers engage consumers from pre-enrollment through the life of their selected qualified health plan (QHP). We go above and beyond standard call center services by managing the total relationship lifecycle. Rather than taking inbound calls only and stopping at enrollment, we proactively engage members throughout the life of their plan to help them make the most of their benefits.

We do this because we want consumers to feel good about their health plan — the price they’re paying, the doctors in their network and the benefits they’re receiving. If they’re unsatisfied with even one of these elements, they may change or cancel their coverage.

Optum contact centers provide: 
  • Service through multiple communication channels. We find that consumers are more responsive to engagement when it is conducted through their channel of choice. We offer phone, text, web and social media, as well as walk-in facilities and mobile teams of outreach specialists. The right message through the right channel at the right time makes it easier for consumers to learn their options, compare benefits, enroll in the right plan and access health and benefits information throughout the life of their policy.
  • Personalized engagement. Our analytics-driven software platform guides engagement specialists to the right conversation for the circumstance, enabling them to respond to a wide range of needs. Our engagement specialists can assist with the enrollment process, verify whether a particular doctor is in the network, schedule appointments and offer information on treatments, medications and symptom support.
  • Proactive messaging. Enrollment in a health plan triggers follow-up communications based on member medical history and best practices. Customized alerts — sent through the member’s preferred communications channel, such as email, text, instant messaging or phone — remind members of scheduled appointments, recommend preventive care and point out other actions requiring attention. We can also send tailored health and wellness information based on the member’s age, sex and health risk assessment or build the tools of your choice, including microsites.
  • Fast and flexible implementation. Our contact center services are flexible — we can add or modify services quickly, to meet your objectives. We typically implement a contact center in 90 to 120 days. Our web-based services have minimal impact on your internal infrastructure and IT resources.
  • Contact center staff grounded in the health care industry. Optum employs highly trained health engagement specialists and certified nurses. Our consumer support team translates the complexities of the health insurance marketplace into language everyone can understand, empowering the consumer to make more cost-effective and appropriate health care decisions.


Our results demonstrate our worth

We have more than 15 years’ experience developing and operating private health care marketplaces for some of the country’s leading payers. Our contact center statistics speak to our success:

  • 75 million consumer interactions handled each year
  • High satisfaction rates among our clients and their members:
    • “Member experience scores consistently exceed 97%, with quality scores of 93% or higher.” — a large national health plan
    • Reduced disenrollment, from 18.7% to 10.6%” — a large national Medicare plan
  • Health risk assessment completion rate of more than 79 percent in 2013 among commercial carrier clients

Contact us today to learn how Optum can build or remediate your contact center for continual engagement and high consumer satisfaction.

*Connextions HCI LLC is our licensed general agency in each state and the District of Columbia.