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.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.The Senior Clinical Administrative Coordinator will provide administrative support to the NY MLTC plan and MCO complex populations in relation to enrollment, dis - enrollment, transfers, assessment, and roster and file management and provider and member communication. The business operations specialist will work closely with entitlement, eligibility and clinical assessment staff to provide a seamless transition for members, and maintain a supportive relationship with providers, Maximus and LDSS.Primary Responsibilities:Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providersManage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census rolesProvide appropriate triage and care coordination notification cases for non - clinical assessment / interventionProcess notification requirementsAssist the clinical staff with setting up documents / triage cases for Clinical Coverage ReviewHandle resolution / inquiries from members and / or providers that may include:Benefit and Eligibility informationAuthorization for treatmentExplanation of Benefits (EOB)
Required Qualifications:High School Diploma / GED2+ years of Microsoft Office experience (Word, Excel and Outlook)2+ years of Operation experience in a healthcare / managed care setting1+ years of Medicaid regulations experience Preferred Qualifications:Bachelor's Degree (or higher)Business knowledge including standard prior authorization processKnowledge of Center for Medicare Services (CMS) RegulationsKnowledge of Prior Authorization Case turnaround times (TAT)Knowledge of MLTC Enrollment and Eligibility processSoft Skills:Strong writing and documentation skillsOrganizational skillsCreativityGood customer service skillsCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.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.Keywords: UHG, New York, customer service, healthcare, telephonic, patient interaction, field based, advocacy
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.