Health Services Coordinator (51680)

About the role

This position, under the direction of the Supervisor, Heath Services Coordination, provides administrative support for utilization review, health education and care management. This includes data entry, communication with members, providers, and vendors for education and information gathering.

Responsibilities

• Following Medicare/Medicaid Timelines for Notification to Provider/Members to meet department goals and requirements.
• Voice and/or written outreach to members and/or providers to provide updates on referral request status, reasoning behind decisions, and provide accurate information.
• Daily Mail fulfillment - faxes to provide notification to provider or member of decisions,
• Coordination of services for members, including community resources and collaboration with assigned case manager
• Develop and maintain resources related to the department.
• Support departmental initiatives.
• Identify and report process improvement opportunities.
• Manage and document member and provider calls.
• Enter authorization requests in the medical management systems.
• Process member notifications.

Qualifications

• High School diploma or equivalent and two years of data entry experience in an administrative support position required.
• Experience working with medical records preferred.
• Experience working in managed care or utilization management environment preferred.
• Strong attention to detail.
• Excellent communication skills, Clear and effective written and verbal.
• Organization and time management skills, including ability to prioritize tasks.
• Strong working knowledge of Microsoft Word, Visio, Excel and Power Point.
• Strategic and Analytic thinking, Lean Six Sigma Green belt or Black belt- preferred.
• Ability to work independently and with a group.
• Self-motivated.
• Excellent customer service skills.
• Demonstrated knowledge of managing the use of a SharePoint site or equivalent application.