Care Team Associate - Remote in Houston, TX

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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.

This position is full time. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 AM - 5:00 PM.

We offer 2 - 3 weeks of paid training. The hours during training will be 8:00 AM - 5:00 PM CST from Monday - Friday.

If you are located within 100-mile commutable distance to the office at 4700 W Sam Houston Pkwy North, Houston, TX, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Documents 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.
• 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 Rightfax.
• Coordinates 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.
• 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 members.
• Performs 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.
• Participates in market Patient Care Committees: prepares agenda, documents minutes and distributes to appropriate venue
• Schedules and coordinates patient transportation, follow - up physician appointments in all applicable markets, as applicable.
• Completes timely data entry of in - bound and / or out - bound call member contact information into software applications (Claims Database, TruCare, etc.).
• 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 participates in ad hoc committees as needed.
• Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies.
• Maintains monthly logs for Notice of Medicare Non - Coverage (NOMNC) per delegation requirements and distributes to management.
• Performs all other duties as assigned.

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
• Must be 18 years of age OR older
• 6+ months of administrative support experience
• Ability to work independently with some supervision and direction from manager
• Possess medical terminology knowledge base
• Possess and demonstrate excellent organizational skills, customer service skills, including verbal and written communication
• Ability to maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
• Ability maintain strict confidentiality at all times
• Ability to adhere to all department / organizational policies and procedures
• Advanced knowledge of Microsoft Office products, including Microsoft Word, Microsoft Excel, and Microsoft Outlook
• Ability to travel up to 10% of the time (Domestic)
• Ability to work any shift between the hours of 8:00 AM - 5:00 PM

Preferred Qualifications:

• Certified Medical Assistant training OR certification
• 2+ years of experience in a physician's clinic OR hospital
• 2+ years of administrative support experience
• Additional experience with working in a medical care setting as a receptionist OR medical assistant
• Bilingual fluency in English and Spanish

Telecommuting Requirements:

• Reside within 100-mile commutable distance to the office at 4700 W Sam Houston Pkwy North, Houston, TX
• 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

Physical and Work Environment

• 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 properly drive and operate a company vehicle
• Ability to receive and comprehend instructions verbally and / or in writing
• Ability to use logical reasoning for simple and complex problem solving

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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