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Senior Clinical Administrative Coordinator - Tennessee Telecommute

UnitedHealth Group

Brentwood, TN
Job Code:
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Job Details

740876 Senior Clinical Administrative Coordinator Tennessee Telecommute

Senior Clinical Administrative Coordinator - Tennessee Telecommute (740876)

Position Description

Position Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

The Senior Clinical Administrative Coordinator – will serve as a support for the Population Health Clinical Operations team. This individual will be an intake point for coordination requests from service providers, complete referrals to appropriate support departments (i.e. CHOICES, Case Management, Private Duty Nursing, Behavioral Health, etc), The CAC - Sr. will interface with provider and TennCare while working through Valid Factual Disputes, On Request Reports (ORRs) and Requests for Information (RFIs).

Primary Responsibilities
  • Serves as the primary intake point for all care coordination requests Pop Health clinical operations.
  • Researches, locates and facilitates local community resources available to help meet member needs and completes referrals as appropriate.
  • Represent the members’ interests including, but not limited to coordinating care, QM/QI activities, program monitoring and evaluation, as well as member, family, and provider education.
  • Assists clinical care teams (PDN, HFS, Health Risk Management) to address member non-clinical issues and navigation of the health plan. Escalates issues as appropriate.
  • Works to ensure member satisfaction. Identifies member dissatisfaction risks and escalates and / or resolves as appropriate.
  • Work through Valid Factual Disputes, ORRs and RFIs as assigned
  • Assist with reporting deliverables as assigned
  • Coordinates with internal departments, including DSNP, CHOICES, FIDE and Medical/Behavioral Care Management for care collaboration
  • Performs other related functions as assigned.

Required Qualifications:
  • High School Diploma / GED or higher
  • 2+ years of customer service experience analyzing and solving customer problems
  • Experience using a computer and Microsoft Office - Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables), and Microsoft Outlook (email and calendar management)
  • Experience with member benefits of TennCare.
Preferred Qualifications:
  • Clinical experience (Medical Assistant or LPN)
  • Experience working with community resources available to resolve non clinical service needs and quality of life issues
  • Experience working with Medicare and / or Medicaid Services
  • Project coordination experience
  • Knowledge in Medical Terminology
Soft Skills:
  • Ability to manage and prioritize multiple tasks efficiently and effectively.
  • Excellent communication and organizational skills.
  • Ability to work independently and within a team.
  • Ability to relate to diverse populations
  • Excellent customer service skills and professional demeanor necessary.
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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.

Keywords:UHG, customer service, healthcare, telephonic, patient interaction, advocacy, Tennessee

Job Details

  • Contest Number740876
  • Job TitleSenior Clinical Administrative Coordinator - Tennessee Telecommute
  • Job FamilyMedical and Clinical Operations
  • Business SegmentCommunity and State

Job Location Information

  • Brentwood, TN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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