AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
Care Management Associate - Knoxville, TN
Position Description:
The primary purpose of the position is to provide administrative support in coordinating, authorizing and processing services required by the Primary Care Team, and to triage incoming calls according to established guidelines.
Primary Responsibilities:
- Triage incoming calls within the phone processing benchmarks
- Communicate accurate and appropriate information to providers and members regarding eligibility and benefit coverage
- Perform authorization data entry and coordination of services through proactive collaboration and communication with Care Coordinators and the Primary Care Team
- Utilize Plan software to enter service requests and document service coordination and service delivery
- Coordinate ancillary services according to policies
- Refer clinical decisions beyond level of authority to Care Coordinator, Care Coordinator Supervisor or Health Services Manager for review and decision
- Serve as member advocate and facilitator to resolve issues that may be perceived as barriers to care
- Conduct telephonic screenings according to Medicare guidelines for community-based members
- Provide information and coordination of community resource referrals to members and providers
- Communicate with other members of the health care team to improve the quality and efficiency of health care delivery and assure smooth transition of service coordination activities to other team members
- Ensure promotion, implementation, and compliance with TN Long Term Care Choices policies and protocols
- Participate in required review processes including recognition of quality of care issues and forward information to appropriate staff for review and resolution
- Perform other duties as assigned
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Qualifications
Qualifications:
- Minimum of 2 years experience in health care related field required
- Minimum of 1 year of customer service experience required
- Minimum of 2 years of professional computer experience required
- Intermediate Outlook experience required
- Intermediate Word, Excel and Access experience preferred
- Working knowledge of Medicare/Medicaid regulations
- Telephonic customer service experience
- Long term care experience
- BS or BA degree
- Excellent organization, communication and time management skills
- Strong team player and team building skills
- Strong interpersonal skills
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Click Here To Apply