10 days old

Senior Healthcare Services Coordinator - Remote in Dallas Fort Worth - 909377

Fort Worth, TX 76102 Work Remotely
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  • Job Code
    909377

Careers with Optum. We built an entire organization around one giant objective; make the health system work better for everyone. 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 an elite team. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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The Senior Healthcare Services Coordinator is responsible for a range of provider relations services within Optum. The Senior Healthcare Services Coordinator will work as an extension of the local Provider Performance Team by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of membership. The Senior Healthcare Services Coordinator under the supervision of a Director/ Manager and or Mentor is responsible for the successful program implementation, compliance with network requirements, network assessment and selection, and program/product implementation.

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Primary Responsibilities will include the following:

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  • Locate medical screening results/documentation to ensure the closure of gaps in care/suspect medical conditions. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff
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  • Activities may include data collection, data entry, quality monitoring, In Office Assessment submission and chart collection activities
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  • Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members
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  • Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources
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  • Anticipate customer needs and proactively develop solutions to meet them
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  • Interaction with members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities
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  • Answer inbound calls from patients and/or providers regarding appointments
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  • Assist members in navigating their network of providers by assisting with follow-up and specialist appointments as needed
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  • Communicate scheduling challenges or trends that may negatively impact outcomes
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  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity
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  • Manage time effectively to ensure productivity goals are met
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  • Ability to work independently and problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise Adhere to corporate requirements related to industry regulations/responsibilities
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  • Maintain confidentiality and adhere to HIPAA requirements
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  • Function independently, meeting with physicians to discuss OPTUM tools and programs focused on improving the quality of care for Commercial, Medicare & Medicaid Advantage Members
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  • Mentor Health Service Coordinators
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  • Ability to travel within assigned territory (day trips) 80% of the time
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  • Other duties, as assigned
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  • Generate and analyze weekly/monthly report data to support provider group success & engagement
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  • Regularly review rejected submissions and proactively assist in their resolution.
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  • Assist with large group presentations and training provider office staff on Optum portals
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  • Establish and build strong relationships with both internal team members and provider office staff to foster a collaborative environment.
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Youll 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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Required Qualifications

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  • High school diploma/GED and undergraduate degree or equivalent work experience.
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  • 1+ year of a healthcare background with medical terminology familiarity of clinical issues
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  • 1+ year of working experience with Microsoft Tools: Word, Excel and Outlook.
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  • 1+ year of working experience with and knowledge of HIPAA compliance requirements
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  • Experience with Managed Care and Medicare programs; prior experience with commercial and Medicare regulations is strongly preferred
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  • 1+ years of provider network management, healthcare consulting, provider relations, Medicare Advantage sales or pharmaceutical sales experience strongly preferred
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  • Willingness and ability to work in the field at least 75% of the time
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Preferred Qualifications

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  • Experience working in a physician, provider, and/or medical office is preferred
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  • EMR and HEDIS knowledge and experience preferred.
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  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities
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  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect
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  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s).
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  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
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  • Experience working in a collaborative team environment
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  • Exceptional written and verbal communication skills
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  • Ability to work independently and remain on multi-task; ability to and prioritize and meet deadlines, duties based on customer and business needs
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  • Project management experience
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UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

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You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here.

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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.

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UnitedHealth Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Key Words: UHG, healthcare, Network Program Specialist, Telecommute, Travel, fieldwork, Dallas, Fort Worth, Texas

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Posted: 2021-02-16 Expires: 2021-03-22

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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Senior Healthcare Services Coordinator - Remote in Dallas Fort Worth - 909377

UnitedHealth Group
Fort Worth, TX 76102

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