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Care Team Associate for WellMed - Dallas, TX more...
Location:Dallas, TX
Company:OptumCare
First posted:June 06, 2017
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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

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 UM processes with WellMed Medical Directors, physicians, hospitals, and any other necessary Health Plan or MSO external departments. This position is responsible for the daily coordination of weekly Patient Care Committee (PCC) Meetings. This position will serve as a liaison with external departments to ensure optimal customer service.

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 complex case screening and 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, reminder calls, census management and distribution of materials to appropriate clinical personnel or patients

Performs daily preparation of Inpatient Census to include monitoring of UM concurrent in-patientcases in pend and informs Care Management Manager of outstanding cases ensure adherence to CMS regulations

Participates in market Patient Care Committees: prepares agenda and minutes

Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as needed

Completes timely data entry of in-bound and / or out-bound call contact information into software applications (Claims Database, Trucare, etc.)

Utilizes various reports to track patient referrals or no-shows for scheduling visits for patients in collaboration with Care Management staff and Clinic staff

Provides clerical and / or administrative support to clinical staff and managers for special studies, projects and reports

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)

Performs all other duties as assigned

Required Qualifications:

High School Diploma or GED

2years of administrative support experience

Basic knowledge of Microsoft Office products, including Word and Outlook

Must be able to work independently, with some supervision and direction from manager

Possesses medical terminology knowledge base

Must possess and demonstrate 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

Must maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times

Must maintain strict confidentiality at all times to include but limited to patients and coworkers

Must comply with all organizational policies regarding ethical business practices

Must adhere to all department policies and procedures
Preferred Qualifications:

Certified Medical Assistant training or certification

2or more years of experience in a physicians clinic or hospital

Additional years of experience working in a medical care setting as a receptionist or medical assistant

Bilingual language proficiency (English/Spanish)
Physical & Mental Requirements:

Ability to lift up to 25 pounds

Ability to push or pull heavy objects using up to 25 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

Ability to use logical reasoning for simple and complex problem solving

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 90,000+ 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: associate, patient care, coordinator, Dallas, Texas, TX

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