Care Coordinator Utilization Agent

Responsible Duties

• Maintains bed tracker for Moanalua Medical Center.
• Collaborates with House Supervisor, Emergency Room, etc. for bed placement and patient throughput.
• Sets up beds at Moanalua Hospital for patients requiring an inpatient admission.
• Outreach to non-Kaiser Permanente hospitals for coordination and repatriation of Kaiser Health Plan members.
• Affords assistance with coordination of Air & Ground Transportation.
• Affords assistance with referral entry in Tapestry for Kaiser Health Plan members admitted to non-Kaiser Permanente facilities.
• Provides timely response to incoming calls and triages calls to appropriate provider.
• Initiates data collection from incoming call, to include: patient information and demographics, eligibility, and reason for call. May also document in the Kaiser Permanente electronic medical record.
• Affords assistance with data entry in electronic medical record, computerized data management systems, and manually maintained data files.
• Collaborates with other services, e.g. membership services, to answer inquiries and educate patients, physicians and hospitals on covered benefits and charges.

Qualifications

• Minimum six (6) months of administrative experience in a health care facility or related experience.
• High School Diploma or General Education Development (GED) required.
• Experience applying analytic techniques and computer skills to hospital data.
• Strong analytic and verbal skills.
• Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes.
• Knowledge of health plan benefits.
• Understanding of medical center operations, complex health systems, with the ability to quickly grasp regional policies, contract interpretation of out-of-plan medical services.
• Must be able to work in a Labor/Management Partnership environment.
• Associate of Arts or Bachelors degree preferred.