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Team Lead, Utilization Management Coordinator, Healthcare, WellMed - San Antonio, TX

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

Team Lead, Utilization Management Coordinator, Healthcare, WellMed - San Antonio, TX(Job Number:727412)

Up for the challenge of a lifetime? Join and lead a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of our millions of customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)
This position is located near NW PKWY, 78249. The hours for this position are Monday - Friday 9am to 6pm.  There will be some required shifts as needed on Saturdays/Sundays/Holidays.
The Team Lead UM Coordinator provides support to the UM department in administrative functions. This position utilizes knowledge of Medicare and HMO guidelines in order to facilitate and comply with the Utilization Management plan utilizing and established policies and procedures.  The Team Lead UM Coordinator will provide float coverage for the UM department as a resource to staff and support to the supervisor. 
Primary Responsibilities:
  • Assist with monitoring of daily work/tasks assigned by supervisor
  • Serves as administrator for RightFax folder, TruCare queues to assist with work distribution to coordinators
  • Assist with tracking and reporting statistical information regarding volume, trends and provide feedback for efforts to meet department needs
  • Ensures requests are being processed efficiently and accurately to support quality measures
  • Assist with performing audits as assigned
  • Assists UM agents with department  processes and updates
  • Provides new employees with post training support and essential tools / resources / references
  • Serve as a knowledge experts to assist with questions from team members in regards to daily work
  • Assists with provider issues, complaints and provides guidance as assigned
  • Receives and responds to telephone calls through the UM phone systems
  • Prepares administrative files for other medical management areas as assigned
  • Performs daily report reconciliation
  • Monitors UM inventory to ensure adherence to CMS regulations
  • Participates in Medical Management as needed for clerical support
  • Maintains knowledge of benefits, network, CMS regulations and policies
  • Non-clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information
  • Effective communication with UM Supervisors and Directors
  • Performs all other related duties as assigned

Job Patient Services
Primary Location US-TX-San Antonio
Other Location US-TX-Shiner-Texas, US-Texas, US-TX-Yoakum-Texas, US-TX-Gonzales, US-TX-NEW BRAUNFELS, US-TX-BOERNE, US-TX-SEGUIN, US-TX-Helotes, US-TX-FLORESVILLE
Organization WellMed Medical Mgmt, Inc
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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