The job below is no longer available.
You might also like
in Irvine, CA
- Starting at $16.15
Verified per hour ACE Hardware • 2d agoUrgently hiring 11 mi Use left and right arrow keys to navigate - $23.00-$24.00
Verified per hour ACE Hardware • 2d agoUrgently hiring 11 mi Use left and right arrow keys to navigate - $68000 - $78000
Verified per year BJ's Restaurants • 2h agoUrgently hiring Use left and right arrow keys to navigate 
$21.00 - $23.00Verified per hour Redwood Family Care Network • 4h agoUrgently hiring 18.2 mi Use left and right arrow keys to navigate
WALGREENS • 30d agoUrgently hiring 14.2 mi Use left and right arrow keys to navigate
Senior Business Operations Coordinator - Irvine, CA
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Irvine, CA Irvine, California |
About this job
Position Description:
of the most successful physician groups in Orange County comes together
with a global leader in health care? Opportunity. With Monarch
HealthCare joining Optum and the UnitedHealth Group family of companies,
people like you will find increasing levels of challenge, impact and
professional success. With a vibrant network of hospitals and urgent
care centers, we're changing health care for the better by improving
access to affordable, high quality care, and working together to improve
the patient experience. That takes passion, commitment, intense focus
and the ability to contribute effectively in a highly collaborative team
environment. Are you with us? Learn more about this exciting
opportunity to do your life's best work.SM
Positions in this function include those responsible for providing process and operational support to the functions within Business Operations Family. Positions in this function may also be responsible for quality reporting, analysis and audits, and for developing plans and programs to support continuous quality improvement using applicable tools.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Primary Responsibilities:
- Conduct
Initial assessments for the Pioneer ACO Care Team including research
and identification of ACO patients, verification of insurance
eligibility, and opening of clinical service records with preliminary
information. - Process requests as assigned within established timeframes.
- Enter
applicable requests into on-line system for encounter data capture and
adhere to Medicare Coverage and Policy statements when checking benefits
on behalf of and under the supervision of the Care Team nurses. - Research all administrative issues before directing to the Care Team Nurses.
- Manage calls for the Pioneer ACO Care Team utilizing standard protocols.
- Utilize various on line systems to access required information.
- Assist
with the coordination of discharge planning and enrollment into
clinical programs, under the direction of the Care Team Nurse. - Provide
outreach, screening and education to physicians, office staff,
patients, family or caregivers when appropriate, as directed. - Collaboratively work to develop, foster and improve the departmental communication processes.
- Act
as effective resource for Clinical Services Department staff,
inter-departmental staff, Network and Non network Providers that support
ACO members. - Actively participates in in-services, training, staff
meetings, and other departmental meetings/committees consistent with
Monarch HealthCare?s core ideals and values. - Create, maintain and process system reports and data logs as required.
- Follow record management and documentation protocols.
- Maintain confidentiality of all member information and ACO business.
- Maintain a professional demeanor at all times.
- Regular and consistent attendance.
- Other duties may be assigned.
Requirements
Required Qualifications:
- High School Diploma or GED is required
- Strong understanding of Medical terminology is required
(certification is not required) - An understanding of health plan eligibility and health
care benefits - Must have experience utilizing customer service skills
over the phone - Microsoft Office, Word and Excel basic proficiency
- Minimum of two (2) years working experience (preferably in
the managed care field)
Preferred Qualifications:
- General knowledge of managed care, third party payers,
regulatory requirements, and government entitlement programs - Medicare advantage knowledge is preferred.
Optum helps nearly 60
million Americans live their lives to the fullest by educating them about their
symptoms, conditions and treatments; helping them to navigate the system,
finance their healthcare needs and stay on track with their health goals. No
other business touches so many lives in such a positive way. And we do it all
with every action focused on our shared values of Integrity, Compassion,
Relationships, Innovation & Performance
At
Optum, you will perform within an
innovative culture that's focused on transformational change in the Healthcare
system. You will leverage your skills across a diverse and multi-faceted
business. And you will make contributions that will have an impact that's
greater than you've ever imagined.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Your Privacy Choices