
Care Team Associate - National Remote
- Eden Prairie, MN
- $41,600-74,300 per year
- Permanent
- Full-time
- Documents all member interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA 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, CM/UM electronic platform, portal, department e-mail box or RightFax
- Coordinates and assists in monitoring of documentation Care Management queues for Complex Case Management, Disease Management, Transitional Case Management, and Social Work referrals
- CTA processes CM 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: member scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members
- Performs daily preparation of INPT and Post-Acute Census for use in CM referrals, and informs Care Management Manager of outstanding cases to ensure adherence to NCQA regulations
- Completes timely data entry of in-bound and/or out-bound call member contact information into software applications
- Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
- Provides excellent customer service by serving as a resource to all internal and external customers
- Attends required meetings and participate in ad hoc committees as needed
- Maintains knowledge of all health plan benefits, network, NCQA regulations, health plan policies
- Identifies opportunities for process improvement in all aspects of member care
- Must maintain strict confidentiality at all times
- Must adhere to all department/organizational policies and procedures
- Performs all other related duties as assigned
- High School Diploma / GED
- Must be 18 years of age OR older
- 2+ years of administrative and/or clinical support experience
- Proven intermediate knowledge of Microsoft Office products, including Microsoft Excel, Microsoft Word, and Microsoft Outlook
- Ability to toggle between multiple IT systems and platforms
- Proven medical terminology knowledge base
- Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
- Ability to work full-time, Monday - Friday between 8:00am - 5:00pm EST including the flexibility to work occasional overtime given the business need
- Certified Medical Assistant training or certification
- 2+ years of experience in a physician's clinic or hospital
- 1+ years of experience working in a medical care setting as a receptionist or medical assistant
- Experience working with a Special Needs Plan (SNP) population
- Ability to work independently, with some supervision and direction from manager
- Posses and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
- Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service