GardenGroveRecruiter
the smart solution for Garden Grove jobs

Case Manager Coordinator - La Palma, CA

Company: UnitedHealth Group
Location: Garden Grove
Posted on: August 19, 2018

Job Description:

Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact. Schedule: Saturday-Wednesday 8am-4pm Office based in La Palma, CA Primary Responsibilities:

  • Manage administrative intake of members or the admission/discharge information post notification
  • Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers
  • Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
  • Receive care coordination notification cases for non - clinical assessment / intervention and provide appropriate triage
  • Facilitates the authorizations for discharge planning
  • Coordinate in network hospital transfers
  • Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
  • Handle resolution/inquiries from members and/or providers:
    • Benefit and Eligibility information
    • Billing and Payment issues
    • Customer material requests
    • Physician assignments
    • Authorization for treatment
    • Explanation of Benefits (EOB)
    • Verifying appropriate ICD - 9 and CPT coding usage Required Qualifications:
      • HS Diploma or GED
      • Greater than 1 year experience in managed care environment or medical office or clinic setting
      • Knowledge of UM /Inpatient processes
      • Knowledge of general IPA operations Preferred Qualifications:
        • Bilingual Spanish speaking preferred
        • Computer literate in Microsoft Word and Excel
        • Knowledge of medical terminology
        • Knowledge of medical coding
        • Strong ability to work effectively with nurses, physicians and other clinical and operational staff, both written and verbally AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

          Keywords: UnitedHealth Group, Garden Grove, Case Manager Coordinator - La Palma, CA, Executive, Garden Grove, California

          Click here to apply!

          Didn't find what you're looking for? Search again!


          I'm looking for
          in category
          within


Other Executive Jobs


Occupational Health RN Manager (Ref #11976)
Description: Occupational Health RN who has 5 years of Occupational Health experience. This position does require travel as you will be overseeing 6 Occupational health clinics for a large corporation. Three of the (more...)
Company: CKM Staffing
Location: Redondo Beach
Posted on: 09/19/2018

Construction Project Manager
Description: San Diego, CAJoin one of the Top Growing General Contractors in the San Diego Area. They have the area's most high profile projects and an Awesome company Culture.Led by some the most highly successful (more...)
Company: LavaRock LLC
Location: San Diego
Posted on: 09/18/2018

Director Software Development/Web Applications
Description: Sharp HealthCare br Facility:Sharp HealthCare CitySan Diego DepartmentISD Web Development Job Status br br Full-Time br br Shift br br Day Job br br FTE br br 1.0 br br Shift (more...)
Company: Sharp Healthcare
Location: San Diego
Posted on: 09/18/2018


Operations Manager (Skilled Laborer)
Description: We are seeking an Operations Manager to become a part of our team We are looking to hire a knowledgeable skilled laborer to manage site projects and supervise project workers. Duties include the over-site (more...)
Company: St. Nick's Commercial Design and Decor
Location: Long Beach
Posted on: 09/18/2018

RN Nurse Manager Emergency Department / ER
Description: RN Nurse Manager ED / Emergency Room Registered Nurse Sign-on Bonus Relocation Assistance ED Manager Job Requirements: Minimum Education: BSN Trauma experience will be highly beneficial 5 years clinical (more...)
Company: Core Medical Group
Location: Fountain Valley
Posted on: 09/18/2018

Medical Director - Global Medical Affairs Lead - Multiple Myeloma
Description: Medical Director - Global Medical Affairs Lead - Multiple Myeloma The Global Medical Affairs Lead GMAL is accountable for the development and execution of global medical affairs strategy for Amgen's (more...)
Company: Amgen
Location: Newbury Park
Posted on: 09/18/2018

Director of Engineering (TMS) -
Description: br br Director of Engineering TMS br br br br Location br br br br Simi Valley, CA br br br br Employment type br br br br Regular - Full Time br br br br (more...)
Company: AeroVironment International
Location: Simi Valley
Posted on: 09/18/2018

Registered Nurse - Nurse Manager (North PACT)
Description: Executes position responsibilities that demonstrates leadership, experience, and creative approaches to management of complex patient care. The Nurse III registered nurse is an EXPERT nurse, with an (more...)
Company: US Department of Veterans Affairs
Location: San Diego
Posted on: 09/18/2018

Project Manager ? Oracle Cloud Solutions (Ref #12320)
Description: The Project Manager assists the team with understanding the diverse business needs of each client and the implementation of various Oracle E-Business Suites EBS and Oracle ERP Cloud applications based (more...)
Company: Recruiting Experts
Location: El Segundo
Posted on: 09/18/2018

Branch Administrative Manager -
Description: Branch Administrative Manager Our team has a proven track record of success built on independent producers who also enjoy team work. We have the processes, training, products and support that will enable (more...)
Company: Pacific Office Automation
Location: Los Angeles
Posted on: 09/18/2018

Log In or Create An Account

Username:
Password:
 

Forgot password?


Find us on Facebook

Find us on LinkedIn

Get the latest California jobs by following @recnetCA on Twitter!

Garden Grove RSS job feeds