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in Fort Myers, FL

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Hours Full-time, Part-time
Location Fort Myers, FL
Fort Myers, Florida

About this job


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-patient cases 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

Requirements

Required Qualifications:


High School Diploma or GED required
Two years 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
This position requires AHCA level II background checks (fingerprinting) by the state of FL for all clinicians that have face to face contact with members or employees who have access to confidential patient data and will require renewal every five years.
Preferred Qualifications:


Certified Medical Assistant training or certification preferred
Two or more years of experience in a physician’s clinic or hospital preferred
Additional years of experience working in a medical care setting as a receptionist or medical assistant
Bilingual language proficiency (English/Spanish)

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: 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: WellMed, Healthcare, Bilingual, Care Team Associate, CTA, Patient Care, Medical Assistant, MA, Clinic, Patient Care Technician, Patient Services Rep, Fort Myers, Port Charlotte, Cape Coral, Naples, Lehigh Acres, Florida, FL