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.
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.
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. This position entails: managing incoming calls, facilitating the transfer of records to the in home clinical team and other MCO?s in the state, managing requests for services from providers / health care beneficiaries, providing information on available network services and transferring members as appropriate to clinical staff. This role manages referrals processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles as well as service as a resource to persons in need of assistance with benefit access.
Serve as a supportive resource for staff or members regarding medical / behavioral / clinical services or benefits
Extract and review fax requests for medical or clinical services
Receive calls requesting medical / behavioral / clinical services or benefits information (e.g., from staff, providers or members
Receive electronic referral form requests for medical / behavioral / clinical services
Utilize phone system to respond to and transfer calls to appropriate individuals
Ask callers standard questions to understand requests, gather necessary information, and assess urgency
Access electronic member files and be able to determine benefit eligibility
Determine member eligibility for both Medicaid and Medicare
Follow protocols to task requests appropriately in the clinical documentation system
Access claims information
Review and interpret call history documentation (e.g., case notes)
Upload and file care plan and other member assessments
Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information)
Assists with the facilitation around Medicare covered services and / or community based services
Contact internal resources as well as other MCOs and DSNPs if necessary to clarify information
Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests
Schedule, take minutes and task follow-up items from Interdisciplinary Care Team meetings
Provide information regarding appointments and medical services to facilities staff to assist members
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.