Care Team Assistant - Ft. Myers, FL

WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health.  WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients.  WellMed is now part of the Optum  division under the greater UnitedHealth Group umbrella.
 
Do you have compassion and a passion to help others?  Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
 
Primary Responsibilities:

Receives and responds to escalated Care Coordination inquiries from all communication venues: e.g. phone queue, 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 Inpatient Census reconciliation to include monitoring of UM concurrent in-patient cases in pending status to ensure adherence to CMS regulations
Participates in market Patient Care Committees: prepares agenda and minutes
Assembles and mails various educational materials, supplies, and medical equipment to patients and clinical staff based on need and direction from nursing personnel
Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as needed
Completes effective data entry of in-bound and / or out-bound call contact information into software applications (Claims Database, DM database, and EMR, CWQI, etc.)
Utilizes various reports to track patient referrals or no-shows for scheduling visits with clinical staff
Completes calls / assignments and ensures census management, productivity weekly and monthly standards are met
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
Performs other duties as assigned
Coordinates all aspects of IDTC from data mining and reporting by market, scheduling, notification to members, preparing agenda and recording of minutes
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)Non-Clinical staff are not responsible for conducting any UM review activities that require interpretation of clinical information
Performs all other duties as assigned

Required Qualifications:


High School Diploma or GED

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
If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.
 
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: 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.
 
 
 
Job Keywords: customer service, associate patient care coordinator, telephone communication, patent service representative, Ft. Myers, FL, Florida