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Senior Clinical Administrative Coordinator - (Honolulu) in Honolulu, Hawaii For Sale

Type: Medical, For Sale - Private.

Position Description: Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, UnitedHealth Group is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, UnitedHealth Group is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing your life's best work. (sm) What makes your clinical career greater with UnitedHealth Group? You'll work within 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. Primary Responsibilities: Act as a Subject Matter Expert for other team members Manage the intake of members or the admission/discharge information post notification Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention Process notification requirements Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review Handle resolution/inquiries from members and/or providers that may include: Benefit and Eligibility information, Billing and Payment issues, Customer material requests, Physician assignments, Authorization for treatment, Explanation of Benefits (EOB), Verifying appropriate ICD-9 and CPT coding usage Answer inbound calls in call center and document all calls Make outbound calls to enroll members into Disease & Wellness programs Schedule appointments in support of various programs Collaborate with disease and 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 eg 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 new 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 (xxxx/xxxx) 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 and other internal systems 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 Extensive work experience within own function. Work is frequently completed without established procedures. Works independently May act as a resource for others. May coordinate other's activities.
Source: http://www.juju.com/jad/xxxxxxxxlkno7n?partnerid=af0exxxx314cbc501beebacaxxxx739d&exported=True&channel=staticfile&hosted_timestamp=xxxxa345f27ac5dcxxxx798fxxxxxxxx09bffe8c43bd05c997be3df16d0fe4e7

State: Hawaii  City: Honolulu  Category: Medical
Medical in Hawaii for sale

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