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Care Team Associate PHM Healthcare WellMed San Antonio TX

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

Job Description:

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)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 SNP processes with WellMed Medical Directors, physicians, hospitals, and any other necessary Health Plan or MSO external departments. This position is responsible for the daily communication to members, physicians and other care management team. This position will serve as a liaison with external departments to ensure optimal customer service. -This is an office-based position located near -Interstate Highway I-10 West, near West Frontage Road just past The Rim Shopping Center/Ferrrari Dealership, 78257Primary 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 transition/complex case screening and 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, census management and distribution of materials to appropriate clinical personnel or patients
  • Performs daily preparation of daily referrals to include Transitions discharge from Inpatient, LTAC, SNF, ARU and informs Care Management Manager of outstanding cases ensure adherence to CMS regulations
  • Completes timely data entry of in-bound and/or out-bound call contact information into software applications (Ecw, EPRG, Trucare, etc.)
  • Provides clerical and/or administrative support to clinical staff and managers for special studies, projects, reports and ordering of supplies i.e., weight scales
  • 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 assignedYou'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 or GED
    • 2+ years of administrative support experience
    • Knowledge of medical terminology
    • Basic knowledge of Microsoft Office products, including Word and OutlookPreferred Qualifications:
      • Certified Medical Assistant training or certification
      • 2+ years of experience in a physician's clinic or hospital
      • Experience working in a medical care setting as a Receptionist or Medical Assistant
      • Ability to work independently, with some supervision and direction from manager
      • Demonstrated 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
      • Ability to maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
      • Ability to maintain strict confidentiality at all times to include but limited to patients and coworkers
      • Ability to comply with all organizational policies regarding ethical business practices
      • Ability to adhere to all department policies and proceduresPhysical & Mental Requirements:
        • Ability to lift up to 25 pounds
        • Ability to push or pull heavy objects using up to 25 pounds of force
        • Ability to sit for extended periods of time
        • Ability to stand for extended periods of time
        • Ability to use fine motor skills to operate office equipment and/or machinery
        • Ability to receive and comprehend instructions verbally and/or in writing
        • Ability to use logical reasoning for simple and complex problem solvingCareers 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 550,000+ 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)WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, San Antonio , Care Team Associate PHM Healthcare WellMed San Antonio TX, Healthcare , San Antonio, Texas

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