Care Team Associate Concurrent Authorization Healthcare WellMed Telecommute - 2030033

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic stat that understands and care about the patient’s health. WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.

 This position requires working various shift hours and rotating / required weekends. 

The Care Team Associate (CTA) for prior authorization department will effectively support the successful implementation and execution of all Utilization Management programs and processes. The Care Team Associate will provide support to the Utilization Management staff to ensure applicable program processes and operational responsibilities are met. The CTA will prepare the authorization by seeking out medical records to the providers via phone or fax, and once completed it is sent to the nurse for review. This position will also provide support in troubleshooting any authorization related issues identified by the Medical Management staff. This position will also assist with training and orientation of new staff and will serve as a subject matter expert for existing staff to ask questions.

If you are located in within a WellMed Location in TX or FL, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

Receives and responds to inquiries from all communication venues: e.g., phone, queue, department e-mail box or fax

Coordinates and assists initial screening of prior authorization requests via all communication venues, as well as administrative preparation for clinical staff

Exhibits excellent phone and communication skills while providing complete and accurate information to customers

Requests additional or supplemental information via correspondence in order to complete prior authorization requests

Completes prior authorizations in the WellMed prior authorization system according to approved policies and procedures

Compiles and reports data for ongoing key performance indicators and summarizes and presents findings to departmental leadership. Notifies manager of trends they observe

Adheres to assigned schedule and quality metrics

Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports

Provides excellent customer service by serving as a resource to all internal and external customers

Attends required meetings and participates in special committees as needed

Assists with training and onboarding of Utilization Management Care Team Associates

May act as a team lead for projects and departmental initiatives as assigned

Performs 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 or GED

2+ years of administrative support experience

Possesses medical terminology knowledge base

General knowledge of CPT, and ICD-10

Working knowledge of Microsoft Office, Internet and e-mail 

Preferred Qualifications:

Certified Medical Assistant training or certification

2+ years of experience with prior authorization or claims 

Able to work independently, with some supervision and direction from manager

Possess and demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers

Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times

Maintain strict confidentiality at all times to include but limited to patients and coworkers

Comply with all organizational policies regarding ethical business practices

Adhere to all department policies and procedures

Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.