Senior Clinical Administrative Coordinator - Westerville, OH - Full-time / Part-time

Position Description:

UnitedHealth
Group is working to create the Healthcare system of
tomorrow and you can help. Already Fortune 17, we are totally focused on
innovation and change.  We work a little
harder. We aim a little higher. We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.

 

Through our family of businesses and a lot of inspired individuals, we're
building a high-performance Healthcare system that works better for more people
in more ways than ever. Now we're looking to reinforce our team with people who
are decisive, brilliant and built for speed. 
Join with us and start doing your life’s best work.SM

In this position, you will be a live outreach team member located in the OH Quality Management and Performance department responsible to perform Member and Provider Outreach to close gaps in care, promote HEDIS and quality performance measures as required by the OH Department of Medicaid (ODM) and NCQA compliance This position demands high focus on quality improvement measures and the increase of member compliance with measures. Position requires the ability to sit for long periods of time during call engagement. Primary Responsibilities:Ability to address customer/member needs in a sensitive, proactive wayAbility to document all outreach calls using UHC systemsFacilitate with member and provider office with scheduling of appointmentsActs as a customer service advocate in providing assistance to resolve member's issues and problemsCoordinates outreach with case management, behavioral health, and other departments to ensure all members' needs are metWhen appropriate, would need to escalate members to other resources for specialized supportHigh focus on quality improvement measures including HEDIS and population health measuresResearch issues across multiple databases to resolve member gaps in careDevelop relationships with other support staff and partners to assist member with closing gaps in careWork independentlyAdministrative point of contact for QMP departmentSupport QMP Committees and Committee StructuresAssist with data collection which may include provider office visitsIndependently performs varied administrative duties related to functional areasPerforms other related projects and duties as assignedDemonstrate the ability to build and maintain productive working relationship with others and contribute as an effective team member

Required Qualifications:Associate's Degree or High School Diploma/GED with 2+ years of call center experience2+ years of experience in customer service2+ years of professional office experience using both the telephone and computer as primary instruments3+ years experience working with Microsoft Excel (data sorting and filtering); Word (documentation) and Outlook (send and receiving emails)Preferred Qualifications:Bachelor's DegreeHEDIS, ODM, and NCQA experienceExperience working with CPT and ICD10 codesAny healthcare or insurance benefits experienceKnowledge of OH Medicaid programCertification in one of the following RHIT, CPC, or CPBSoft Skills:Ability to manage multiple priorities in a fast-paced environmentCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life’s best work.SMDiversity 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.Keywords: customer service, call center, intake, prior authorization, medical assistant, administrative, clerical, coordinator, claims.