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Senior Care Coordinator
1 month ago
About UsBrighton Health Plan Solutions is a leading provider of Utilization Management services to its clients. We are seeking a Senior Care Coordinator to join our team. The successful candidate will be responsible for facilitating care management and utilization review by performing data collection, data entry, and effectively communicating with Nurse reviewers and leaders' employers and claimants in regard to their requests for preservice, prospective, and concurrent reviews.
Key Responsibilities- Partner with leadership in cross-training team members in all non-clinical departmental functions.
- Create cases within the clinical platform while adhering to policies, procedure, and defined workflows.
- Support Clinical staff as needed with administrative needs including but not limited to: outbound fax requests, telephonic communications, and reporting compilation.
- Data entry of required clinical documentation as received via fax or portal submissions.
- Telephonic interactions with physicians and/or representatives to acquire information or relay medical determination updates.
- Perform Ad-Hoc projects and support departmental initiatives as needed.
- Strong PC skills (Excel is a must).
- Excellent organizational skills including written and oral communication skills.
- Ability to work independently and as a team player.
- Minimum of one year's experience.
- Bilingual preferred, but not required.
- History working in medical records review, an MA or ancillary staff member preferred.
About Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you'll become part of a diverse and welcoming culture focused on encouragement, respect, and increasing diversity, inclusion, and a sense of belonging at every level. Here, you'll be encouraged to bring your authentic self to work with all of your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today's healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today's challenges into tomorrow's solutions.
