New York, NY – Telecommute
Location: New York New York United States
Division:OH Ops-PHM Medicaid
Contest Number: 815063
Title: Clinical Administrative Coordinator
Telecommute New York, NY
Family: Medical and Clinical Operations
Function: Clinical Admin & Processing
BusinessSegment: Optum Consumer Solutions Group
Region: North America
Country: United States
City: New York
State: New York
Energize your career with one of Healthcare’s fastest growing companies.
You dream of a great career with a great company ? where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Groupis restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum ? a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.
Optumhelps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
Like you, UnitedHealth Groupis strong on innovation. And like you, we’ll go the distance 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 a chance to make an impact.
This is high volume, customer service environment. You’ll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.
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. *Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
Manage administrative intake of members
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and / or providers
Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
Handle resolution / inquiries from members and / or providers
Moderate work experience within own function
Some work is completed without established procedures
Basic tasks are completed without review by others
Supervision / g…
Administrative , Medical & Health