Care Team Associate

Care Team Associate (CTA)

Optum NY/NJ, is seeking a Care Team Associate (CTA) to join our team in Fishkill, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and erience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country.

Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Care Team Associate (CTA) will effectively support the successful implementation and execution of all Care Management (CM) processes for Complex Case Management (CCM), Disease Management (DM), Transitional Case Management (TCM), Emergency Department (ED) Follow-Up, and Social Services (SS) programs. The CTA will provide support to care management team including CM manager, CM Director, and CM Vice President to ensure applicable program processes and operational responsibilities are met.

The CTA provides support for CM processes. This position is responsible for daily census management, task management, and general coordination functions. This position will serve as a liaison with internal/external customers/departments to ensure optimal customer service.

Schedule:

A 40-hour work week, Monday through Friday and 8-hour shift between the hours of 8 am to 5:00pm. The schedule will be determined by the supervisor upon hire.

Location:

600 Westage Drive, Third Floor Fishkill, NY 12524 - Possibility of working three days a week from home.

If you reside in Fishkill, NY, you will enjoy the flexibility of an Office-Based role as you take on some tough challenges.

• Documents all member interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations
• Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g., phone queue, CM/UM electronic platform, portal, department e-mail box or Right Fax
• Coordinates and assists in monitoring of documentation CM queues for CCM, DM, TCM, ED Follow-up and SS referrals
• CTA processes CM requests via all communication venues; as well as administrative preparation for clinical staff
• Conducts in-bound and out-bound calls for program requirements including, but not limited to: member scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members
• Performs daily preparation of INPT and Post-Acute Census for use in CM referrals, and informs CM Manager or designated Registered Nurse Lead of outstanding cases to ensure adherence to NCQA regulations
• Completes timely data entry of in-bound and/or out-bound call member contact information into software applications
• Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
• Provides excellent customer service by serving as a resource to all internal and external customers
• Attends required meetings and participates in ad hoc committees as needed
• Maintains knowledge of all health plan benefits, network, NCQA regulations, health plan policies
• Identifies opportunities for process improvement in all aspects of member care
• Must maintain strict confidentiality at all times
• Must adhere to all department/organizational policies and procedures
• Performs all other related 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.

• High School Diploma /GED
• 2+ years of administrative support experience
• 2+ years of medical terminology knowledge base
• 1+ years of computer proficiency experience in Microsoft Office and demonstrates solid computer skills
• 1+ years of ability and knowledge to toggle between multiple IT systems and platforms
• Must live…