Requisition number: 1060750
Job category: Medical & Clinical Operations
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start C aring. Connecting. Growing together.
The Clinical Administrative Coordinator is responsible for the management of the census data for accurate bed day reporting. Inpatient, skilled nursing and acute rehab cases are created in the appropriate UM applications and routed to the Clinical Administrative Coordinator for coverage determination, eligibility verification, and routing to the assigned facility nurse as per the Priority Review (PR). The Clinical Administrative Coordinator is responsible for capturing the most accurate census data possible, timely discharge date entry, managing future scheduled admissions, and referrals to the applicable case management and disease management programs, while meeting the turnaround time goals to support timely clinical review.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 AM - 6:00 PM including the flexibility to work rotating weekends and holidays based on business need. Training will be conducted virtually from your home.
Training is for 1 week from 8:00am-4:00pm Central.
Primary Responsibilities:
Manage notifications and case validation using standard process documents
Route Priority Review inpatient cases from Intake to ICM and Generic work queue within required timeframe
Focus on data integrity and accuracy for multiple downstream dependencies
Foster collaborative working relationships with facilities, vendors, medical groups, internal clinical and non-clinical staff
Orient new and existing facilities to the notification requirements / process
Adhere to a work schedule based on business needs including weekend and holiday rotations
Make timely case corrections based on the Health Care Economics Exception Reports
Meets expected quality and productivity standards
Be able to review benefit documents and quote INN and OON benefits
Perform other duties assigned within the role
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 equivalent work experience
Must be 18 years of age OR older
2+ years of customer service experience
Experience in working with Microsoft Office, including Microsoft Word (ability to create, edit, save, and send documents), Microsoft Excel (ability to create, edit, save, and send documents), Microsoft Outlook (ability to create, edit, save, and send documents)
Understanding of basic medical terminology
Ability to work any shift between the hours of 8:00 AM - 6:00 PM from Monday - Friday Central Time. including the flexibility to work rotating weekends and holidays based on business need
Preferred Qualifications:
Ability to perform ICD - 10, CPT, and HCPC coding
Health care OR health plan experience
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
Ability to work independently or with teams using process documents
Comfort level to make out bound calls to facilities and provider offices
Effective communication skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
