Medical Management Care Coordinator, Utilization Management

VNS Health; New York (NY); On-site; USD 125,000 - 150,000; Full time

Job summary

Ein etabliertes Unternehmen im Gesundheitswesen sucht einen engagierten Mitarbeiter für das medizinische Management. In dieser Rolle unterstützen Sie das klinische Team, indem Sie Daten sammeln und in das System eingeben, um eine effiziente Bearbeitung von Anfragen und Beschwerden zu gewährleisten. Sie werden Teil eines dynamischen Teams, das sich für die Verbesserung der Gesundheitsversorgung in der Gemeinschaft einsetzt. Mit umfangreichen Weiterbildungsmöglichkeiten und einem unterstützenden Arbeitsumfeld bietet diese Position die Chance, Ihre Karriere im Gesundheitswesen voranzutreiben und einen positiven Einfluss auf das Leben der Menschen zu haben.

Benefits

Referral bonus opportunities

Generous paid time off (20 days)

Health insurance plan

Employer-matched retirement savings

Tuition reimbursement

Personal and financial wellness programs

Qualifications

• Mindestens zwei Jahre Erfahrung im Kundenservice erforderlich.
• Ausgezeichnete mündliche und schriftliche Kommunikationsfähigkeiten.

Responsibilities

• Daten in das medizinische Managementsystem eingeben zur Unterstützung klinischer Bewertungen.
• Kundenbeschwerden verfolgen und Trends melden.

Skills

Kundenservice

Kommunikationsfähigkeiten

PC Kenntnisse (Word, Excel, Access)

Problemlösungsfähigkeiten

Education

High School Diploma

Job description

Overview

Collects specific data in the medical management information system for the clinical staff. Resolves authorization issues as well as troubleshoots, researches, and resolves related issues in a timely and efficient manner. Works under general supervision.

Job Description

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, including Medical, Dental, Vision, Life, and Disability
• Employer-matched retirement savings funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, CEU credits, and advancement opportunities
• Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals

What You Will Do

• Obtain information from doctors and providers and enter data into the medical management information system to support clinical assessments.
• Create case files requiring authorization and maintain accurate data in all applicable systems for prompt decision-making and claims processing.
• Deliver strong customer service and problem solving while managing calls with accuracy and meeting performance targets.
• Track and monitor customer complaints, report trends, and recommend corrective actions.
• Provide feedback to leadership on training needs.
• Collaborate with management to improve service delivery, billing, and payment processes.
• Protect confidentiality of member information in accordance with policies.
• Participate in special projects and perform other duties as assigned.

Qualifications

• Education: High School Diploma or equivalent required
• Work Experience:
• Minimum of two years in a customer service role required
• Excellent oral and written communication skills required
• Advanced PC skills, including Word, Excel, or Access required
• Utilization Management experience preferred

Compensation

$20.98 - $26.23 Hourly

About Us

VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. With over 130 years of innovation, we are committed to health and well-being, helping people live, age, and heal in their own homes. More than 10,000 team members serve over 43,000 neighbors daily, providing compassionate care, expertise, and 24/7 resources. Powered by unmatched data analytics, we offer comprehensive health care services and solutions designed to meet diverse community needs in New York and beyond.