BH UM CARE COORDINATOR
4 weeks ago
Job Ref: 106285
Category: Utilization Review and Case Management
Department: BEHAVIORAL HEALTH HARP
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $52,000.00
Salary Range: $52,000.00 - $55,000.00
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The Behavioral Health UM Care Coordinator provides comprehensive service and support to providers and members as needed. The primary responsibilities include but are not limited to: responding to all provider inquiries for Behavioral Health Core and HARP authorizations, documenting such contacts into the tracking clinical system, manage and maintain inbound queues for the UM work system, process complaints, conduct outreach efforts to providers and ensure all activities deliver a seamless and streamlined experience for both UM staff and providers. This position requires that one be organized, ability to multitask, set priorities and manage time effectively.
Job Description
* Responsible to manage large amounts of inbound provider calls promptly.
* Record and respond to all BH UM Customer contacts and update the tracking system.
* Manage and ensure appropriate follow-up and closure for all provider/member contacts.
* Manages calls to and from providers regarding both inpatient and outpatient BH authorizations
* Enter prior approvals in the authorization System (CareConnect) and follow internal process for connecting providers to the Clinical UM Staff as applicable.
* Notifies vendors of the start date of the services to member
* Monitors the assigned queues in the authorization system (Care Connect) to ensure timely processing of service authorization requests
* Tracks and monitors key information identified by the UM Team Leaders for quality purposes
* Maintain clinical work queues to ensure tasks are sent timely to UM team members
* Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM customer service associate level and collaborate with other BH UM team members to ensure that the entire team is also successful at meeting those standards.
* Process and resolve complaints, record given information in the clinical management system
* Handle provider inquiries and escalates to Call Center Supervisor appropriately
* Respond to all claim billing inquiries from providers and members and direct them to the correct teams.
* All other duties and special projects as assigned by BH UM Call Center Supervisor and BH UM Director
Minimum Qualifications
* Associates Degree required; Bachelor's Degree preferred
* A minimum of 3 years' experience in customer service; 1 year must be in a UM medical management call center setting
* Experience in providing excellent customer service in a fast-paced, high volume type medical setting (i.e., insurance, doctor's office, medical clinics) Bilingual (English/Spanish) - written and verbal skills required
* Basic Microsoft Word, Teams, and Excel skills; familiarity with Microsoft Teams is a plus
* UM clinical operations expertise a bonus
Professional Competencies
* Integrity and Trust
* Customer Focus
* Functional/Technical skills
* Written/Oral Communication
* Ability to multitask and work as a team
* Must be able to work well under pressure and handle stressful situations effectively
* Ability to maintain a positive and customer friendly attitude while fielding calls
-
New York, United States MetroPlusHealth Full timeThe Behavioral Health UM Care Coordinator provides comprehensive service and support to providers and members as needed. The primary responsibilities include but are not limited to: responding to all provider inquiries for Behavioral Health Core and HARP authorizations, documenting such contacts into the tracking clinical system, manage and maintain inbound...
-
BH Care Manager Team Lead
2 weeks ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
BH Care Manager Team Lead
4 weeks ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
BH Care Manager Team Lead
1 week ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. Please ensure you read the below...
-
BH Care Manager
2 weeks ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
BH Care Manager
2 weeks ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
BH Care Manager
2 weeks ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
Manager, Data
4 days ago
New York, United States UM Worldwide Full timeBusiness Overview UM is a global media agency committed to Futureproofing our clients' businesses. We leverage the transformational power of rich business analytics and real-time intelligence to maximize growth and activate the full consumer journey across content and connections. As the leading global media network in IPG Mediabrands, UM operates in over...
-
Um Care Manager
2 days ago
New York, United States MetroPlusHealth Full time**Empower. Unite. Care.**: **MetroPlusHealth** is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. **About NYC Health + Hospitals**: MetroPlus**Health...
-
Lead, Inpatient UM Nurse Capped
1 week ago
Los Angeles, CA, United States MedPOINT Management Full timeSummaryJob DescriptionProvides leadership, support, training, and direction to the Inpatient UM teammates. The incumbent will use clinical judgment to provide utilization management review for inpatient during high volume situations. Provide high quality, cost-effective care to enable patients to achieve maximum medical improvement, while receiving care...
-
Senior Director of Behavioral Health Strategy
2 weeks ago
New York, United States NYC Health + Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
Senior Director of Behavioral Health Strategy
4 weeks ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
Bel Air, MD, United States University of Maryland Medical Center Baltimore Washington Full timeJob Description UM Upper Chesapeake Health (UM UCH), a member of the University of Maryland Medical System (UMMS), has a Full-time employed position available for a Nurse Practitioner Program Coordinator to join their reputable, well-established Comprehensive CARE Center (a transitional care clinic) located on the UM Upper Chesapeake Medical Center campus...
-
Bel Air, MD, United States University of Maryland Medical System Full timeCompany DescriptionUniversity of Maryland Upper Chesapeake Health (UM UCH) offers the residents of northeastern Maryland an unparalleled combination of clinical expertise, leading-edge technology, and an exceptional patient experience.A community-based, integrated, non-profit health system, our vision is to become the preferred, integrated health system...
-
Care Management Supervisor
1 week ago
New York, United States Village Care Full timeJob DescriptionJob DescriptionCare Management Supervisor - RNVillageCareMAX 112 Charles Street, New York, NY 10014VillageCare is looking for a self-motivated and passionate RN with previous Care Management experience for our Care Management Supervisor position. This role is responsible for oversight of staff, productivity, the care transition program, and...
-
Senior Care Manager- BH
4 days ago
United States Magellan Health Full timeAuthorizes and reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity; provides member assistance with mental health and substance abuse issues, and participates in quality improvement...
-
Care Coordinator
2 months ago
New York, United States Hamaspik Care Full timeJob DescriptionJob DescriptionGrowing Home Care Agency is seeking a full-time Care Coordinator to join our team in our Brooklyn Office. The successful candidate will be responsible for managing the scheduling of staff, ensuring that all shifts are filled and that all staff are properly trained and informed of their duties. The Care Coordinator will also be...
-
Behavioral Health Pediatric Navigator
4 days ago
New Haven, United States Fair Haven Community Health Care Full timeFair Haven Community Health Care FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 130,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services,...
-
Behavioral Health Pediatric Navigator
5 days ago
New Haven, United States Fair Haven Community Health Care Full timeFair Haven Community Health Care FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 130,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as...
-
Behavioral Health Pediatric Navigator
3 days ago
New Haven, United States Fair Haven Community Health Care Full timeJob DescriptionJob DescriptionFair Haven Community Health Care FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 130,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary...