UNITE HERE HEALTH

  • UR Intake Coordinator

    Job Locations US-NV-Las Vegas
    Posted Date 4 weeks ago(5/21/2018 9:43 AM)
    ID
    2018-1453
    # of Openings
    1
    Category
    Other
    Company
    Culinary Health Fund
  • Overview

    CHF logo with A division of UHH

     

     

    Our mission-driven organization is focused on the “Triple Aim” - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.

     

    The Culinary Health Fund serves over 50,000 workers in the hospitality and gaming industry. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

     

     

    Key Attributes:

     

    • Integrity – Must be trustworthy and principled when faced with complex situations

    • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required

    • Communication – Ability to generate concise, compelling, objective and data-driven reports

    • Teamwork – Working well with others is required in the Fund’s collaborative environment

    • Diversity – Must be capable of working in a culturally diverse environment

    • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise

    • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)

     betterworkplaceuhh

    Responsibilities

     

    The Intake Coordinator performs a variety of duties. The majority clerical and customer service in nature. The position purpose of the Intake Coordinator is to facilitate utilization review by performing data collection, completing data entry and effectively communicating with the Utilization Review team in regards to individual participants.

     

    • Adhere to established URAC standards and all Nevada Health Solutions LLC. policies and procedures
    • Contributes to UM program goals and objectives in containing health care costs and maintaining a high quality medical delivery system through the program procedures for conducting UM activities;
    • Must become knowledgeable of URAC requirements for clinical staff for UM accreditation
    • Collect data upon notification from patient/patient representative, physician, or hospital.
    • Excellent customer service skills
    • Is kind, caring, sympathetic and positive with all customers and fellow employees.
    • Interact telephonically with participants, hospital staff, physician staff, and physicians to determine medical status, type of care requested (surgery, hospitalization and/or physical therapy
    • Maintain accurate records of individual cases.
    • Inform callers that the Nurse Case Manager will review the medical information for review and certification; if information is available, caller will be transferred to Nurse.
    • Collects only pertinent clinical information and documents all UM review information using the appropriate software system;
    • Follows relevant time frame standards for conducting and communicating UM review determination;
    • Maintains and submits reports and logs on review activities as outlined by the UM program operational procedures;
    • Maintains courteous, professional attitude when working with the Client’s staff, hospital and physician providers, and all ancillary providers;
    • Active participation in team meetings
    • Performs other duties as assigned within the scope of responsibilities and requirements of the job

    Qualifications

    Skills:

    • Minimum level computer skills in a Microsoft Office environment: Intermediate
    • Bi- or Multi- lingual skills (written and verbal): Strongly Desired
    • Excellent written and verbal communication skills
    • Excellent interpersonal skills – ability to express compassion and balance the emotions with business needs
    • Excellent customer service and communication skills
    • Working knowledge of utilization management preferred
    • Strong problem solving and decisions making skills essentialAbility to:                                                

     

    Abilities:

    • Perform the essential function of this job with or without reasonable accommodation
    • Ability to multitask in a fast-paced environment

    Education:

    • HS diploma or GED is required

     

    Knowledge/Experience:

    • Minimun 2 years of experience in Customer Serivce
    • Experience as an intake specialis with a healthcare or utiliization management company preferred
    • Experience in healthcare environment

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