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IEHP
IEHP
1001 – 5000 Zaposleni
LogistikaSvetovanjeZavarovanje
IEHP je regionalni zdravstveni načrt, ki nudi storitve posameznikom in družinam z nizkimi dohodki v okrožjih Riverside in San Bernardino. Organizacija, ustanovljena leta 1995, zagotavlja zdravstveno kritje prek programov Medi-Cal, DualChoice in Covered California. Sodeluje z lokalnimi zdravniki in zdravstvenimi ustanovami ter članom pomaga pri dostopu do zdravstvenih storitev. Njen pristop, usmerjen v skupnost, vključuje tudi podporo duševnemu zdravju, programe telesne vadbe in izobraževanje o zdravju ter dobrem počutju.
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Delovna mesta v podjetju

Non-Routine Placement Coordinator

Coordinate health plan referrals, eligibility checks, and member discharges in a hybrid role at IEHP. Support nurses, providers, and care teams with accurate medical management records.

USZdružene države AmerikeCAKalifornija
23 $ – 30 $ / ura
HibridnoPolni delovni časJuniorSrednja ravenDiploma ni potrebnaZahtevani Jezik: angleščinaSplošno

Opis

  • Keep member face sheets accurate and up to date with current demographic details.
  • Monitor RightFax, the EDI interface, and medical management system to process incoming cases promptly.
  • Review daily census reports and remove duplicate or unnecessary admissions.
  • Confirm member eligibility and route authorizations to the appropriate NRP nurse using the Far tool.
  • File reviews and orders in the medical management system for NRP nurse review.
  • Confirm member discharge dates through calls, electronic medical record reviews, or submitted memos.
  • Process program referrals and member discharges promptly.
  • Request additional medical information from providers by phone, fax, or email.
  • Coordinate with providers and facilities on program referrals, orders, and clinical reviews.
  • Support NRP nurses with care coordination for members who have care management needs.
  • Arrange hospital follow-up appointments and share appointment details with members.
  • Record call interactions in the medical management system.
  • Work with internal teams to address member care issues and consult Hospital & Ancillary Department leaders.
  • Help identify HEDIS care gaps and conduct outreach to members.
  • Maintain documentation in line with regulatory and accreditation standards.
  • Contribute to workflow improvements and departmental initiatives.
  • Handle other duties that support health plan operations and department needs.

Zahteve

  • At least two years of data entry experience in a customer service focused environment.
  • Data entry experience in an HMO or managed care setting is preferred.
  • Utilization Management experience is preferred.
  • High school diploma or GED required.
  • Knowledge of ICD-10 and CPT codes.
  • Knowledge of utilization management in a health care delivery setting is preferred.
  • Proficiency with computer applications, including word processing, databases, and spreadsheets.
  • Strong customer service skills.
  • Ability to meet productivity and accuracy performance standards.
  • Ability to represent the organization in a friendly, professional manner when answering calls.
  • Ability to support a positive, collaborative team environment.
  • Ability to attend scheduled meetings.

Ugodnosti

  • Competitive salary.
  • On-site fitness center with modern equipment.
  • Medical, dental, and vision insurance.
  • Life, short-term disability, and long-term disability options.
  • Career growth and professional development opportunities.
  • Wellness programs supporting work-life balance.
  • Health care and childcare Flexible Spending Accounts.
  • CalPERS retirement plan.
  • 457(b) plan with an employer contribution match.
  • Employer-paid life insurance.
  • Pet care insurance.

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