3 days old

Care Team Associate San Antonio TX

San Antonio, TX 78205
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  • Job Code
    872173

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm) 

 

The Care Team Associate (CTA) will effectively support the successful implementation and execution of all Care Management and processes. The Care Team Associate will provide support to the care management case management staff to include CM manager, CM Director, and CM Vice President to ensure applicable program processes and operational responsibilities are met. The CTA provides support for Utilization and Care Management processes. This position is responsible for the daily coordination of weekly Patient Care Committee (PCC) Meetings, daily census management, creates authorizations, and generating written notifications to providers per delegation requirements This position will serve as a liaison with internal/external customers/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, NCQA 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 Rightfax 
  • Coordinates and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes 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, , census management and distribution of materials to appropriate clinical personnel or members 
  • Performs daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in -pend- and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations 
  • Participates in market Patient Care Committees: prepares agenda, documents minutes and distributes to appropriate venue 
  • Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable 
  • Completes timely data entry of in-bound and/or out-bound call member contact information into software applications (Claims Database, TruCare, etc.) 
  • Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs 
  • Provides excellent customer service by serving as a resource to all internal and external customers 
  • Attends required meetings and participates in adhoc committees as needed 
  • Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies 
  • Maintains monthly logs for Notice of Medicare Non-Coverage (NOMNC) per delegation requirements and distributes to management. Performs all other duties as assigned 
  • Must maintain strict confidentiality at all times
  • Must adhere to all department/ organizational policies and procedures

 

 

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.

 

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Posted: 2020-05-21 Expires: 2020-06-20

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Care Team Associate San Antonio TX

UnitedHealth Group
San Antonio, TX 78205

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