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 Management and processes. The Care Team Associate will provide support to the care management case management staff to include CM manager, CM Director, and CM Vice President to ensure applicable program processes and operational responsibilities are met. The CTA provides support for Utilization and Care Management processes. This position is responsible for the daily coordination of weekly Patient Care Committee (PCC) Meetings, daily census management, creates authorizations, and generating written notifications to providers per delegation requirements This position will serve as a liaison with internal/external customers/departments to ensure optimal customer service.

Primary Responsibilities:

* Document all patient 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
* Receive and respond to incoming Care Coordination inquiries from all communication venues: e.g. phone queue, TruCare, portal, claim queue, department e-mail box or Rightfax
* Coordinate and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes UM requests via all communication venues; as well as administrative preparation for clinical staff
* Conduct 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 members
* Perform daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in pend and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations
* Participate in market Patient Care Committees: prepare agenda, document minutes and distribute to appropriate venue
* Schedule and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable
* Complete timely data entry of in-bound and / or out-bound call member contact information into software applications (Claims Database, TruCare)
* Provide clerical and / or administrative support to clinical staff and managers for special projects and reporting needs
* Provide excellent customer service by serving as a resource to all internal and external customers
* Attend required meetings and participate in adhoc committees as needed
* Maintain knowledge of all health plan benefits, network, CMS, regulations, health plan policies
* Maintain monthly logs for Notice of Medicare Non-Coverage (NOMNC) per delegation requirements and distribute to management.

This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.

Required Qualifications:

* High school diploma or GED
* 2+ years of administrative support experience
* Advanced knowledge of Microsoft Office products, including Excel, Word, and Outlook
* Medical terminology knowledge
* This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease
* You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
* Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

* Certified Medical Assistant training or certification
* 2+ years of experience in a physician's clinic or hospital
* Additional years of experience working in a medical care setting as a receptionist or medical assistant
* Bilingual language proficiency (English/Spanish)
* Demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
* Maintain and demonstrate a high degree of professionalism
* Maintain strict confidentiality at all times
* Adhere to all department / organizational policies and procedures
* Work independently, with some supervision and direction from manager

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 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)

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: WellMed, Healthcare, Bilingual, Care Team Associate, CTA, Patient Care, Medical Assistant, MA, Clinic, Patient Care Technician, Patient Services Rep, San Antonio, Austin, Texas, TX