This is remote however they will need to potential come onsite in Phoenix AZ. Your candidate will need to be willing to commute onsite to Phoenix AZ Description: Support comprehensive coordination of medical services including member transitions, screening and supporting the implementation of referrals to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. Create authorizations in QNXT to support continuity of care for member. Screens incoming forms using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services Position Summary The Coordinator III will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis. Provide call center outreach to members related to referrals, gaps in care and services needed. Assist with appointment scheduling, transportation scheduling and referral assistance. Duties Utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources. Will assist with auth creation, appointment scheduling, and outreach to members, referral follow up. Experience call center experiencePreferred strong customer service skillsStrong problem-solving and analytical skillsPossess strong computer navigation skillsComfortable with regular feedback and developmentWorks well in a team environmentMust have basic medical terminology experience Education High school diploma or GED required, 1-2+ years of call center experience. Notes: Mon-Fri 8-5 This is remote however the candidate will need to potential come onsite.VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:
Support comprehensive coordination of medical services including member transitions, screening and supporting the implementation of referrals to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. Create authorizations in QNXT to support continuity of care for member. Screens incoming forms using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services
Position Summary
The Coordinator III will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis. Provide call center outreach to members related to referrals, gaps in care and services needed. Assist with appointment scheduling, transportation scheduling and referral assistance.
Duties
Utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources. Will assist with auth creation, appointment scheduling, and outreach to members, referral follow up.
Experience
call center experience
Preferred strong customer service skills
Strong problem-solving and analytical skills
Possess strong computer navigation skills
Comfortable with regular feedback and development
Works well in a team environment
Must have basic medical terminology experience
Education
High school diploma or GED required, 1-2+ years of call center experience.
Notes:
Mon-Fri 8-5
This is remote however the candidate will need to potential come onsite.
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