Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
The Care Team Associate (CTA) will effectively support the successful implementation and execution of all Care Management and processes. The Care Team Associate will provide support to the care management case management staff to include CM manager, CM Director, and CM Vice President to ensure applicable program processes and operational responsibilities are met. The CTA provides support for Utilization and Care Management processes. This position is responsible for the daily coordination of weekly Patient Care Committee (PCC) Meetings, daily census management, creates authorizations, and generating written notifications to providers per delegation requirements This position will serve as a liaison with internal/external customers/departments to ensure optimal customer service.
- Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA 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 Rightfax
- Coordinates and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes 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, , census management and distribution of materials to appropriate clinical personnel or members
- Performs daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in “pend” and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations
- Participates in market Patient Care Committees: prepares agenda, documents minutes and distributes to appropriate venue
- Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable
- Completes timely data entry of in-bound and/or out-bound call member contact information into software applications (Claims Database, TruCare, etc.)
- Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies
- Maintains monthly logs for Notice of Medicare Non-Coverage (NOMNC) per delegation requirements and distributes to management. Performs all other duties as assigned
High School Diploma or GED
2+ years of administrative support experience
Advanced knowledge of Microsoft Office products, including Excel, Word and Outlook
Medical terminology knowledge base
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)
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: Administrative Assistant, Medical Assistant, El Paso, TX, Texas