Case Manager Assistant SNP - 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.
The core function of this position is assisting with the coordination of care of low-moderate case management to vulnerable populations that populate these programs. 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
- Authorizes selected services per explicit criteria and guidelines
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
- Performs outbound patient calls per clinical pathway
- Facilitates patients appointments as directed by the case manager
- Manages a case load of low acuity patients that are identified for population management by the case manager
- Presents cases to IDT for low risk members with case manager oversight
- Provides feedback to Clinical Services Supervisor regarding process improvement
- Performs data entry
- Prepares tracking reports
- Prepares denial letters
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 in.
- HS Diploma or GED
- 2+ years of customer service experience
- Experience with MS Word, Excel and Outlook
- Case management experience or managed care
- Familiar with medical terminology
- Familiar with medical insurance, IPA, health plans
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
- 1+ years of experience in managed care environment or 3+ years in a medical office or clinic setting as a medical assistant or a referral coordinator
- Knowledge of UM/QM processes and principles.
- Knowledge of medical terminology/ICD-9 and CPT codes
- Bi-lingual Spanish written and verbal fluency skills
- Solidability to work effectively with nurses, physicians and other clinical and operational staff, both written and verbally
- Self motivated with strong organizational skills
- Flexible and adaptable of schedule to attend various meetings and/or promotional events
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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, Inpatient, Prior Authorization, Intake, Call Center, Case Management, Healthcare, La Palma, Cerritos, Buena Park, LA Co