2 days old

Team Lead Utilization Management - Shavano Park, TX

Shavano Park, TX 78231
  • Job Code
    879713

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm) 

 

WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.

 

The Team Lead UM Coordinator provides support to the UM department in administrative functions. This position utilizes knowledge of Medicare guidelines in order to facilitate and comply with the Utilization Management plan utilizing and established policies and procedures. The Team Lead functions as a subject matter expert, and provides guidance to UM Coordinator on more complex issues.


The Team Lead UM Coordinator will provide float coverage for the UM department as a resource to staff and support to the supervisor. 

 

Primary Responsibilities:

  • Assist with monitoring of daily work/tasks assigned by supervisor
  • Serves as administrator for RightFax folder, TruCare queues, Portals, and email box to assist with work distribution to coordinators
  • Assist with tracking and reporting statistical information regarding volume, trends and provide feedback for efforts to meet department needs
  • Ensures requests are being processed efficiently and accurately to support quality measures
  • Assist with performing audits as assigned
  • Provides guidance and acts as a resource to trainers and new hires on benefits, contract interpretations, exclusions, eligibility, policies, standard operating procedures, job aids and workflows to other UM Coordinators in resolving complex issues
  • Provides coaching and education to all coordinators
  • Assists with escalated issues, and provides guidance as assigned
  • Collaborates with management with projects as assigned
  • Non-clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information
  • Effective communication with UM Supervisors and Directors
  • Performs all other related duties as assigned

This is a call center environment near NW PKWY / Weekdays and Weekend shifts required


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Posted: 2020-06-29 Expires: 2020-07-29

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Team Lead Utilization Management - Shavano Park, TX

UnitedHealth Group
Shavano Park, TX 78231

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