Senior Care Coordinator

2 weeks ago


Chapel Hill, North Carolina, United States Brighton Health Plan Solutions, LLC Full time
Job Summary

Brighton Health Plan Solutions, LLC is seeking a Senior Care Coordinator to join our team. As a key member of our Utilization Management department, you will play a critical role in facilitating care management and utilization review.

Key Responsibilities:

  • Partner with leadership to develop and implement cross-training programs for team members.
  • Create cases within our clinical platform, adhering to policies, procedures, and defined workflows.
  • Support clinical staff with administrative needs, including outbound fax requests, telephonic communications, and reporting compilation.
  • Enter required clinical documentation into our system, received via fax or portal submissions.
  • Engage in telephonic interactions with physicians and/or representatives to acquire information or relay medical determination updates.
  • Assist with ad-hoc projects and support departmental initiatives as needed.

Requirements:

  • Strong PC skills, with proficiency in Excel.
  • Excellent organizational and 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 Us:

Brighton Health Plan Solutions, LLC is a healthcare enablement company that partners with self-insured employers, Taft-Hartley Trusts, health systems, providers, and other TPAs to solve the problems facing today's healthcare. Our unique perspective stems from decades of health plan management expertise, proprietary provider networks, and innovative technology platforms.

We are committed to increasing diversity, inclusion, and a sense of belonging at every level. If you're passionate about healthcare and want to be part of a dynamic team, we encourage you to apply.



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