Care Team Associate

About the role

Optum is a clinician-led care organization changing the way clinicians work and live. As a Care Team Associate (CTA) on the Optum Care Delivery team, you’ll support the vision to make healthcare better for everyone by helping patients live healthier lives with the resources, data, and support of a global organization behind you.

Responsibilities

• Support implementation and execution of 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
• 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
• Manage daily census, task management, and general coordination functions
• Serve as a liaison with internal/external customers/departments to ensure optimal customer service
• Document all member interactions in a concise manner compliant with Model of Care, NCQA, and CMS regulations
• Receive and respond to incoming Care Coordination inquiries from phone queue, CM/UM electronic platform, portal, department e-mail, or RightFax
• Coordinate and assist in monitoring documentation CM queues for CCM, DM, TCM, ED Follow-up, and SS referrals
• Process CM requests via all communication venues and provide administrative preparation for clinical staff
• Conduct in-bound and out-bound calls for program requirements including member scheduling, surveys/screenings, census management, and distribution of materials
• Prepare daily INPT and Post-Acute Census for use in CM referrals and inform CM Manager or designated Registered Nurse Lead of outstanding cases to ensure adherence to NCQA regulations
• Complete timely data entry of in-bound and/or out-bound call member contact information into software applications
• Provide clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
• Attend required meetings and participate in ad hoc committees as needed
• Maintain knowledge of health plan benefits, network, NCQA regulations, and health plan policies
• Identify opportunities for process improvement in all aspects of member care
• Adhere to strict confidentiality and all department/organizational policies and procedures

Schedule

A 40-hour work week, Monday through Friday, with an 8-hour shift between 8:00 am and 5:00 pm. Schedule determined by the supervisor upon hire. Possibility of working three days a week from home. Office-based role located at 600 Westage Drive, Third Floor, Fishkill, NY 12524.

Requirements

• High School Diploma or GED
• 2+ years of administrative support experience
• 2+ years of medical terminology knowledge base
• 1+ years of computer proficiency in Microsoft Office with solid computer skills
• 1+ years of ability to toggle between multiple IT systems and platforms
• Must live within a commutable distance to Fishkill, NY
• Access to a designated quiet workspace in your home separated from non-workspace areas with the ability to secure Protected Health Information (PHI)
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications

• Certified Medical Assistant training or certification
• 2+ years of experience in a physician’s clinic or hospital
• Additional years of experience working in a medical care setting as a receptionist or medical assistant

Skills

• Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
• Ability to work independently and as a team, maintaining good judgment and accountability
• Demonstrated ability to work well with healthcare providers
• Strong organizational and time management skills
• Ability to multi-task and prioritize tasks to meet all deadlines
• Ability to work well under pressure in a fast-paced environment
• Excellent verbal and written communication skills; ability to speak clearly and concisely

Physical & Mental Requirements

• Ability to lift up to 25 pounds
• Ability to sit and stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
• All telecommuters must adhere to UnitedHealth Group’s Telecommuter Policy

Pay

The hourly pay for this role ranges from $16.00 to $29.00 per hour based on full-time employment, subject to local labor markets, education, work experience, certifications, and other factors.

Benefits

• Paid Time Off accrued with first pay period plus 8 Paid Holidays
• Medical plan options with participation in a Health Spending Account or Health Savings Account
• Dental, Vision, Life & AD&D Insurance, Short-term and Long-Term Disability coverage
• 401(k) Savings Plan and Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits including pet insurance, legal insurance, and Long-Term Care Insurance