Patient Care Coordinator

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Under the supervision of the Referral Management Center Supervisor, the Patient Care Coordinator position are responsible for the daily coordination of referral processes and other duties as assigned.

Location: 5150 Journal Center Blvd. NE, Albuquerque, NM 87109. Training and coverage may be needed at other Albuquerque and/or Rio Rancho clinics, depending on business need.

Schedule: Monday-Friday, 8am-5pm MST.

Department: Radiology

Primary Responsibilities:

• Manage the internal/ external referral process and daily referral reconciliation gathering required information and documents needed, working them accordingly in compliance with established timelines
• Manage administrative intake of members
• Maintains department records as requested by supervisor, department director and/or other regulatory agencies
• Maintains area according to the following duties;
  • Receives all requests for exam (CD)- check out
  • Processes requests and prepares CD check-out requests according to protocol
  • Receives and processes in the RIS all outside facility in-coming exams
  • Down-load all outside facility exams in PACS
  • Prepares and processes all outside facility exams for return to facility or patient
  • Processes in all returned exams
  • Maintains CD files and purges outdated exams
  • Requests pertinent prior exams for all modalities per protocol
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
• Handle resolution/inquiries from members and/or providers
• This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours
• Performs all other related duties as assigned

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma/GED
• 1+ years of customer service experience in a healthcare setting
• Intermediate level of proficiency in Microsoft Office applications including Excel, Word, and Outlook

Preferred Qualifications:

• Experience working within the healthcare industry and with health insurancee
• Experience working in a hospital, physician's office or medical clinic setting
• Knowledge of ICD-9 and CPT codes
• Previous experience working in radiology
• A clerical or administrative support background
• Previous experience working within an Electronic Health Record (EHR) system
• Demonstrated ability to manage and respond effectively to high call volumes
• Working knowledge of medical terminology and clinical documentation

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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