Clinical Administrative Coordinator LTSS UM Support – Remote in New Mexico

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

 

Like you, UnitedHealth Group is 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. 

As a Clinical Administrative Coordinator, you will be part of a UM management team who will address utilization of services for complex members.  You will support the Secondary review UM clinical team in assignment of HCBS and NFLOC cases team, ensuring all cases are complete, and addressing any administrative issues that arise.

This position is full – time (40 hours / week) Monday – Friday. Employees are required to have flexibility to work any of our 8 – hour shift schedules during our normal business hours of 8am to 5pm.  It may be necessary, given the business need, to work occasional overtime. This position is a remote – based position with a home – based office.

Travel up to 10%.

If you reside in New Mexico, you will enjoy the flexibility to telecommute* as you take on some tough challenges. 

Primary Responsibilities:

• Provide administrative support for LTSS secondary review team and SR UM Manager/RN
• Receive and process electronic referral requests for care management services (HCBS NFLOCS) 
• Tracking all NFLOC and referral assignments that are sent to Secondary Review
• Generating authorization letters in ICUE when a duplicate is needed
• Set up UM Cases in clinical system, monitor work queues and act on requests
• Process all correspondence from Health Services clinical team and address these as directed by Senior UM nurse/manager; this includes mail, fax, email. Responsible to monitor the UM mailbox throughout the day
• Utilize phone system to respond to and transfer calls to appropriate individuals as needed
• Ask callers standard questions to understand requests, gather necessary information, and assess urgency
• Create a positive experience and relationship with the member 
• Practice cultural sensitivity and cultural competence in daily care
• Other clerical/administrative functions as needed to support LTSS UM Department 

What are the reasons to consider working for UnitedHealth Group?  Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• 1+ years of experience in an office setting using the telephone and computer as the primary instruments to perform the job duties, OR in customer service analyzing and solving customer’s problems
• 1+ years of experience with MS Office including Word, Excel, and Outlook
• 1+ years of experience with navigating a PC to open applications, send emails, and conduct data entry
• Must have a designated workspace inside the home with access to high – speed internet availability 
• Ability to remain stationary for long periods of time to complete computer or tablet work duties
• Ability to travel locally up to 10% of the time

Preferred Qualifications:

• Associate’s or Bachelor’s Degree
• Experience working in Managed Care (MCO)
• Knowledge of Medicaid and / or Medicare population
• Experience working in team-based care 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

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.

 

 

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