Senior Clinical Administrative Coordinator
Location: Honolulu Hawaii
Description: UnitedHealth Group is hiring Senior Clinical Administrative Coordinator right now, this career will be placed in Hawaii. Detailed specification about this career opportunity kindly see the descriptions. Position Description:
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You ! can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
Primary Responsibilities:
Answer inbound calls in call center and document all calls
Make outbound calls to enroll! members into Wellness programs
Schedule appointments!
Collaborate with wellness Coaches and Nurses
Assigns and reassigns members to appropriate Care Coordinator under the direction of the
Service Coordination Manager
Monitors member list routinely to assure accurate assignment of all members
Queue Management (EVC/Initial Assessments)
Tracks Nursing Facility and Inpatient census data via the Blended Census Reporting Tool (BCRT)
Communicates member Inpatient status to the assigned Service Coordinator
PCP selection post initial customer service attempts
Updates Member demographic and placement changes in Careone
Assists with administrative/enrollment activities for special programs e.g. disease management, complex case management, behavioral health referrals
Manages incoming communication calls/fax/email/tasking group- members/providers
Assists with outgoing communication (calls/fax/email)
Follow-up to see that ne! w services started, meeting/not meeting needs
Distribute service plans/plan of care, other communication to members/providers
Coordinate details of environmental modifications
Pharmacy issues (customer service)
Completes eligibility related activities- enrollment, disenrollment, tracking Nursing Facility
Level Of Care/Waiver eligibility (1148/1147)
Posts member related documents that can't be stored in CareOne to electronic filing system (shared drive/SharePoint)
Documents all member related activities in CareOne
Reminds members of need to complete Medicaid paper work to maintain eligibility
Utilizes plan software to generate care coordination reports
UTL/Refused Contact process
Assist with requesting HCBS services (find provider, verify hours, and submit task to HCBS)
Assist manager/supervisor/HSD
Performs other duties/projects as assigned.
Requirem! ents
Requirements:
HS Diploma or GED
2 + y! ears of p rofessional experience using the telephone and computer as the primary instruments to perform the job duties
2+ years of professional experience clerical or administrator work
Healthcare Industry Experience
Knowledge of Medical Terminology
Experience and proficiency with Internet Explorer or other web browser, Excel, Word, and Email
Ability to type 45 WP M
Additional Preferred Assets:
Experience working with Med icare and M edicaid h ighly desired.
Experience with Adobe, Snag It, Access, RightFax, SharePoint, Outlook, Visio, Project, Other Clinical Databases
Experience in a Call Center with high volume
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic imp! act on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required! to pass a drug test before beginning employment. In addition, employee! s in certain positions are subject to random drug testing.
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Mon, 15 Apr 2013 17:09:15 GMT
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