Care Team Associate PHM Healthcare WellMed - San Antonio, TX

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 Group is 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.

Optum helps 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.

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 SNP processes with WellMed Medical Directors, physicians, hospitals, and any other necessary Health Plan or MSO external departments. This position is responsible for the daily communication to members, physicians and other care management team. This position will serve as a liaison with external departments to ensure optimal customer service.

This office - based position is full - time. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM. Our office is located at LOCK HILL SELMA RD., SAN ANTONIO, TX, 78249 - SHAVANO PARK OFFICE

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 transition / complex case screening and 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 patients
• Performs daily preparation of daily referrals to include Transitions discharge from Inpatient, LTAC, SNF, ARU and informs Care Management Manager of outstanding cases ensure adherence to CMS regulations
• Completes timely data entry of in - bound and / or out - bound call contact information into software applications (Ecw, EPRG, Trucare, etc.)
• Provides clerical and / or administrative support to clinical staff and managers for special studies, projects, reports and ordering of supplies i.e., weight scales
• 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)

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)
• 2+ years of administrative support experience
• Knowledge of medical terminology
• Basic knowledge of Microsoft Office: Microsoft Word (creating, sharing, and storing documents) and Microsoft Outlook(creating, sending, and storing email correspondence)
• Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• 2+ years of experience in a physician’s clinic OR hospital
• Certified Medical Assistant training OR certification
• Experience with working in a medical care setting as a Receptionist OR Medical Assistant

Soft Skills:

• Ability to work independently, with some supervision and direction from manager
• Demonstrated 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 maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
• Ability to maintain strict confidentiality at all times to include but limited to patients and coworkers
• Ability to comply with all organizational policies regarding ethical business practices
• Ability to adhere to all department policies and procedures

Physical and Work Environment:

• Ability to lift up to 25 lbs. (pounds)
• Ability to push or pull heavy objects using up to 25 lbs. (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
• Performs all other duties as assigned

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company 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.

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