Senior Clinical Administrative Coordinator - Honolulu, HI

Position Description:What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.Primary Responsibilities:Answer inbound calls in call center and document all callsMake outbound calls to enroll members into Wellness programsSchedule appointmentsCollaborate with wellness Coaches and NursesAssigns and reassigns members to appropriate Care Coordinator under the direction of the Service Coordination ManagerMonitors member list routinely to assure accurate assignment of all membersQueue Management (EVC/Initial Assessments)Tracks Nursing Facility and Inpatient census data via the Blended Census Reporting Tool (BCRT)Communicates member Inpatient status to the assigned Service CoordinatorPCP selection post initial customer service attemptsUpdates Member demographic and placement changes in CareOneAssists with administrative/enrollment activities for special programs e.g. disease management, complex case management, behavioral health referralsManages incoming communication calls/fax/email/tasking group- members/providersAssists with outgoing communication (calls/fax/email) follow-up to see that new services started, meeting/not meeting needs distribute service plans/plan of care, other communication to members/providersCoordinate details of environmental modifications pharmacy issues (customer service)Completes eligibility related activities- enrollment, disenrollment, tracking Nursing Facility Level Of Care/Waiver eligibility (1148/1147)Posts member related documents that can't be stored in CareOne to electronic filing system (shared drive/SharePoint)Documents all member related activities in CareOneReminds members of need to complete Medicaid paper work to maintain eligibilityUtilizes plan software to generate care coordination reportsUTL/Refused Contact processAssist with requesting HCBS services (find provider, verify hours, and submit task to HCBS)Assist manager/supervisor/HSDPerforms other duties/projects as assignedExtensive work experience within own function.Work is frequently completed without established procedures.Works independentlyMay act as a resource for others.May coordinate other's activities.

Requirements: High School Diploma or GEDMust be able to navigate a Windows PC and the ability to use/ learn new applications easilyIntermediate proficiency with MS Word with the ability to create/ edit documents, import files, format, etc.Intermediate proficiency with MS Excel with the ability to create/ edit spreadsheets, create formulas, use sort/filter functions, etc. Intermediate proficiency with MS Outlook with the ability to send/ receive emails, use the calendar for scheduling, assign/maintain tasks, etc.Medical or Healthcare industry experience1+ year of experience in clerical or administrative role2+ years of customer service experience and solving customer problemsPreferred Requirements:  Bachelor's Degree or higherMedicaid and/or Medicare experienceCall center experienceExperience working with HIPAA requirementsCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SMDiversity 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.Keywords: UHG, United Healthcare, clinical, administrative, coordinator, clerical, Honolulu, Hawaii, HI