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) In this role, you will supervise and motivate a work team to achieve team objectives, including meeting the company's standards of production and quality while maintaining applicable turnaround times and standards. You will lead by example with a positive attitude and demonstrate the fundamentals of being a team player.What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. In this position, you will ensure that the notification coordinators comply with all applicable State and Federal laws and consent decrees, as well as the applicable accrediting regulatory review agencies, including but not limited to CMS, NCQA, HIPAA, and all UHC policies and procedures as applicable. Primary Responsibilities: Ensure a timely acknowledgement and response to all authorization documents received providing appropriate feedback to address processing issuesAdminister the process for handling authorizations received from non-participating providersRespond to provider inquiries that have been received by the escalation and case resolution department in a timely mannerCommunicate with provider and/or office staff, various health plans administered and/or other employees to research and verify information provided on authorization documents when appropriate using a professional, courteous and cheerful mannerSupervise the process for accurate additions of new patients to the patient databaseFacilitate team staff meetings in order to review and implement processes that allow for smooth and efficient operationsReview with management individualized reports reflecting daily production and quality in order to accurately measure and monitor predetermined company, position and individual goalsWork together with all staff members, as well as other departments, to resolve issues and assist each otherThis team is responsible for reaching out to members to give them a verbal notification of approval or adverse results - Direct Reports:15 +Supervises day to day operations of the notification coordinators by monitoring case load and productivity on a daily basisCompletes Monthly scorecards for the staffResource to staff- knowledgeable about the day to day operations and familiar with P&P's, state grids, resource tools, staff lists (ID's, MS sign-on, phone number list)HR dutiesMonitor queues, work assignments, compliance and adherence to policies and procedures. Monitor and address Reports (error reports, pend reports, etc.) as assignedServes as a catalyst for implementing an appropriate risk assessment process designed to identify and correct deficiencies. Must be innovative and bring new ideas for efficienciesMaintains extensive knowledge of regulatory and applicable accrediting body requirements becoming a Compliance resource for the teamDemonstrates flexibility, availability, and dependability to conform to position responsibilitiesEstablish and maintain good working relationships throughout the company to support goals and objectives
Required Qualifications: Bachelor's degree or equivalent experience in the healthcare field2+ years of Supervisory experience5+ years of Customer Service experience2+ years of experience Supervising in a metrics based environment2+ years' experience with acting as a Subject Matter Expert or Lead with Utilization Management Letter Generation RequirementsIntermediate (or higher) level of proficiency with Microsoft Office Proven analytical and problem solving skills while managing multiple tasks simultaneouslyAbility to work independently or in a team environmentDemonstrated excellent written and verbal communication skills The applicant should possess a high attention to detail, exceptional documentation abilities, and organizational skills Proven ability to handle multiple tasks simultaneously by working independently, as well as part of a team, in a fast paced environmentKnowledge of State Employer and Individual UR / UM Applicability and Medicare Federal Guidelines for Notifications Preferred Qualifications: Managed Care experience in a Care Coordination roleCall Center experiencePrevious experience supervising remote employees Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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: Clinical Administrative Supervisor, Phoenix, Arizona, AZ
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.