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Clinical Administrative Coordinator - National Remote

Company: UnitedHealth Group
Location: San Antonio
Posted on: March 19, 2023

Job Description:

You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work. SM

The Clinical Administrative Coordinator is responsible for the management of the census data for accurate bed day reporting. Inpatient, skilled nursing and acute rehab cases are created in the appropriate UM applications and routed to the Clinical Administrative Coordinator for coverage determination, eligibility verification, and routing to the assigned facility nurse as per the Priority Review (PR) and Secondary Level of Care (SLOC) criteria. The Clinical Administrative Coordinator is responsible for capturing the most accurate census data as possible, timely discharge date entry, managing future scheduled admissions, and referrals to the applicable case management and disease management programs, while meeting the turnaround time goals to support timely clinical review.

This position is full - time, Monday - Friday. Employees are required to work our normal business hours of 8:00 AM - 6:00 PM including the flexibility to work rotating weekends and holidays based on business need. Training will be conducted virtually from your home.

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:


  • Manage notifications and case validation using standard process documents
  • Route Priority Review inpatient cases from Intake to ICM and Generic work queue within required timeframe
  • Focus on data integrity and accuracy for multiple downstream dependencies
  • Foster collaborative working relationships with facilities, vendors, medical groups, internal clinical and non-clinical staff
  • Orient new and existing facilities to the notification requirements / process
  • Adhere to a work schedule based on business needs including weekend and holiday rotations
  • Make timely case corrections based on the Health Care Economics Exception Reports
  • Meets expected quality and productivity standards
  • Be able to review benefit documents and quote INN and OON benefits
  • Knowledge to create referrals in HSR


    You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
    Required Qualifications:


    • High School Diploma / GED (or higher)
    • Health care OR health plan experience
    • Previous experience in working with Microsoft Office, including Microsoft Word (ability to create, edit, save, and send documents), Microsoft Excel (ability to create, edit, save, and send documents), Microsoft Outlook (ability to create, edit, save, and send documents)
    • Ability to perform ICD - 10, CPT, and HCPC coding
    • Understanding of basic medical terminology
    • Ability to work any shift between the hours of 8:00 AM - 6:00 PM from Monday - Friday including the flexibility to work rotating weekends and holidays based on business need


      Preferred Qualifications:


      • Associate's Degree (or higher)
      • Previous CDU experience
      • Previous experience in working with HSR (IQUE)


        Telecommuting Requirements:


        • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
        • Ability to keep all company sensitive documents secure (if applicable)
        • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service


          Soft Skills:


          • Ability to work independently or with teams using process documents
          • Comfort level to make out bound calls to facilities and provider offices


            Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

            California, Colorado, Connecticut, Nevada, Washington or New York City Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York City residents is $16.00 - $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

            At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.



            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.

Keywords: UnitedHealth Group, San Antonio , Clinical Administrative Coordinator - National Remote, Administration, Clerical , San Antonio, Texas

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