Supplemental Utilization Management Coordinator - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 161008
JOB SUMMARY: Primarily responsible for the initiation of cases by data entry of clinical, demographic and product information into the Medical Management system, via telephone, fax or online portal. Electronically routes cases to the nurse for review and decision. Handles data entry of all precertification of inpatient and outpatient service request. Responsible for accurate case completion /quality and productivity standards while staying within compliance timeframes. Handles provider outbound calls according to departmental standards. Provides a high level of customer service while communicating with internal departments and provider office staff as it pertains to performance of job responsibilities. Works independently with minimal supervision.
1. Education/Specialized Training/Licensure: High School Diploma required. Associate?s degree preferred 2. Work Experience (Years and Area): 2 years? data entry experience in a healthcare setting such as medical clinic, hospital, or managed care. 1 year utilization management experience preferred. 3. Management Experience (Years and Area): N/A 4. Software Operated: Microsoft Office (Word, Excel, Outlook)
SPECIAL REQUIREMENTS: (Check Applicable Areas)
1. Communication Skills: Writing /Composing: Correspondence / Reports
2. Other Skills: Analytical, Medical Terminology, MS Word, MS Excel
3. Advanced Education:
Advanced Training Specialty: Associate's degree preferred
4. Work Schedule: Flexible
5. Other Requirements: Able to work independently under general instructions
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.