It's the new age of independence. And it's changing the way we live.
BE PART OF IT.
is dedicated to helping people live and age with independence. By providing a single place to find and manage resources which support independent living,
makes it easier to access care and to age safely at home.
This is your opportunity to join an innovative company with a culture that promotes compassion, trust, and accountability.
ABOUT THIS OPPORTUNITY
In this position, you will provide support and serve as a resource person for the Utilization Management department within our Integrated Home Care division.
Provide Customer Service in the administration of the IHC Programs to include: telephone coverage of customer service lines, data entry of all calls and correspondence, making follow-up phone calls, handling any written correspondence, and other pending service requests.
Provide verification of eligibility and contractual arrangements for types of services per Health Plan specific direction.
Coordinate all services and care per contractual arrangements, policy, and workflow.
Process beneficiary/patient referrals to provider network, staffing cases with appropriate discipline and agency.
Complete appropriate documentation in designated system for all reviews and tasks associated with staffing a case.
Provide assistance to Providers, health plans, other staff, and referral sources while educating and supporting the Utilization Management program.
Handle any provider/beneficiary/health plan calls.
Participate in on-call after hours/weekend/holidays support for the department as scheduled.
1+ years of experience in healthcare or insurance industry
Positive and professional phone presence
Proficient in Microsoft Office and Windows products
Knowledge of medical terminology
Working knowledge of computerized medical management systems and/or web based programs
Strong interpersonal and communication skills including verbal and written communication
Detail-oriented with the ability to work on multiple, competing, priorities and is extremely organized
Ability to analyze processes and suggest innovative ideas to improve efficiencies
offers a competitive and complete benefits package.