Case Manager Assistant Complex - La Palma, CA
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
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.
Facilitates hospitalist orders for discharge planning. Ensures that patients who need inpatient care are admitted to right hospital along with our hospitalist. Also responsible for taking calls from IPA members regarding urgent care facility location and authorization requests. This position is crucial for meeting the requirements of our current Health Plan regulated programs such as Special Needs Population (SNP) and CalMedi Connect (CMC) programs.
- Manage administrative intake of members
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
- Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
- Ensures the appropriate utilization of capitated and contracted specialists, providers, facilities, and vendors according to region and risk. Handle resolution/inquiries from members and/or providers
- Handle resolution/inquiries from members and/or providers
- Carry out discharge plans, schedule necessary appointments, process authorizations
This is high volume, customer service environment. You’ll need to be efficient, productive and thorough dealing with our members over the phone. The pace is fast, so your ability to multi-task is essential. You should also enjoy working with people and have the communication skills necessary to build strong relationships with our patients.
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
- HS Diploma or GED
- 2+ years of experience in a hospital, physician's office or medical clinic setting
- Medical Assistant experience
- Experience with referrals and authorizations
- Experience with MS Word, Excel and Outlook
- Familiar with medical terminology
- Familiar with medical insurance, IPA, health plans
- 2+ years of experience as an inpatient / outpatient coordinator
- Experience working within the health care Industry and with health care insurance
- Experience working in a hospital, physician's office or medical clinic setting
- A clerical or administrative support background
- Knowledge of ICD-10 and CPT codes
- Bilingual- Spanish
- Full COVID-19 vaccination is an essential requirement 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
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.
Key words: Clinical Admin Coordinator, Customer Service, Clinical Administrative Coordinator, Medical Office, Receptionist, Patient Care, Medical Assitant, Inpatient, Prior Authorization, Intake, Call Center, Healthcare, Admitting and Registration Clerk, La Palma, LA County, Southern CA, California