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Care Team Associate - Dallas, TX

Expired Job

Unitedhealth Group Inc. Dallas , TX 75201

Posted 2 months ago

Let's talk about meaningful work, an important role and a career move that can transform your future. At WellMed, a part of OptumCare and the growing UnitedHealth Group family of businesses, we focus on prevention and the complete coordination of care for our patients. Join us and you'll be part of a team dedicated to patient-centered, safe and effective health care. Your skills and talents will make an important impact on our patients while you open doors for yourself that simply do not exist in any other organization.

The Care Team Associate (CTA) will effectively support the successful implementation and execution of all Care Coordination programs and processes. The Care Team Associate will provide support to the care coordination nursing staff and managers to ensure applicable program processes and operational responsibilities are met; to include UM processes with WellMed Medical Directors, physicians, hospitals, and any other necessary Health Plan or MSO external departments. This position is responsible for the daily coordination of weekly Patient Care Committee (PCC) Meetings. This position will serve as a liaison with external departments to ensure optimal customer service.

Hours: Monday-Friday 8am-5pm or 9am-6pm

Primary Responsibilities:

  • Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care and Center for Medicare and Medicaid Services (CMS) regulations

  • Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g. phone queue, Trucare, portal, claim queue, department e-mail box or fax

  • Coordinates and assists initial screening of complex case screening and UM requests via all communication venues; as well as administrative preparation for clinical staff

  • Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, reminder calls, census management and distribution of materials to appropriate clinical personnel or patients

  • Performs daily preparation of Inpatient Census to include monitoring of UM concurrent in-patient cases in "pend" and informs Care Management Manager of outstanding cases ensure adherence to CMS regulations

  • Participates in market Patient Care Committees: prepares agenda and minutes

  • Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as needed

  • Completes timely data entry of in-bound and/or out-bound call contact information into software applications (Claims Database, Trucare, etc.)

  • Utilizes various reports to track patient referrals or no-shows for scheduling visits for patients in collaboration with Care Management staff and Clinic staff

  • Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports

  • Provides excellent customer service by serving as a resource to all internal and external customers

  • Attends required meetings and participates in special committees as needed

  • Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan and/or MSO policies

  • Maintains collating, gathering and logs for Notice of Medicare Non-Coverage (NOMNC)

  • Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times

  • Maintain strict confidentiality at all times to include but limited to patients and coworkers

  • Comply with all organizational policies regarding ethical business practices

  • Adhere to all department policies and procedures

  • Performs all other duties as assigned

Required Qualifications:

  • High School Diploma or GED

  • 2 years of administrative support experience

  • Basic knowledge of Microsoft Office products, including Word and Outlook

  • Medical terminology knowledge base

  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease

Preferred Qualifications:

  • Certified Medical Assistant training or certification

  • 2 years of experience in a physician's clinic or hospital

  • Additional years of experience working in a medical care setting as a receptionist or medical assistant

  • Bilingual language proficiency (English/Spanish)

  • Possess and demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers

  • Ability to work independently, with some supervision and direction from manager

Physical & Mental Requirements:

  • Ability to lift up to 25 pounds

  • Ability to push or pull heavy objects using up to 25 pounds of force

  • Ability to sit for extended periods of time

  • Ability to stand for extended periods of time

  • Ability to use fine motor skills to operate office equipment and/or machinery

  • Ability to receive and comprehend instructions verbally and/or in writing

  • Ability to use logical reasoning for simple and complex problem solving

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000 lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: UM, Care Team Associate, Medicare and Medicaid Services (CMS), CMS, regulations, health plan, Dallas, TX, Texas, customer service, patient service rep, MA, CMA

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Care Team Associate - Dallas, TX

Expired Job

Unitedhealth Group Inc.