Clinical Administrative Coordinator - Milwaukee, WI

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

If you want to achieve more in your mission of health care, you must be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work. (sm)

Like you, United Health Group is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive, and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases.

Bring your skills and talents to a role where you'll have a chance to make an impact. The Clinical Administration Coordinator must reside within a commutable distance to Milwaukee, Wisconsin.

The Clinical Administrative Coordinator will work in a customer service environment. You'll need to be efficient, productive, and thoroughly deal with our members over the phone. Positions in this function include those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff.

Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.

The work schedule is Monday through Friday from 8:00AM to 4:30 PM. No nights, weekends, or holidays.

If you reside near Milwaukee, WI, you will enjoy the flexibility to telecommute as you take on some tough challenges. Office-Based in Milwaukee, WI 1-2 days per week. The remaining days will be telecommute.

• Extensive work experience with Medicaid community
• Maintain 100% adherence to State contract, CMS requirements, and Product & Program Requirement
• 100% adherence to submission timelines of scheduled department reports, assigned metrics and state deliverables
• Monitor the timely receipt and accuracy of State assessments received from Service Coordinators while demonstrating compliance to ensure that all internal and State deadlines are met
• Act as an advocate for our membership and establish effective working relationships with our providers to service our members, ensuring all federal, state and company regulations, policies, and expectations are followed
• Proactively seek the root cause of member and provider issues and promptly communicate with all appropriate business segments of identified issues and potential solution
• Providing essential administrative support to Service Coordinators as a member of the Service Coordination team through spirit of collaboration to ensure efficiency in all administrative areas
• Manage administrative intake of members
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process incoming referrals, and prior authorizations, including intake and notifications
• Moderate work experience within own function
• Some work is completed without established procedures
• Basic tasks are completed without review by others
• Supervision/guidance is required for higher level tasks.

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with…