Intake Coordinator - Utilization Management Post Acute Team

Sanford Health • Sioux Falls, SD

2d • Onsite

About The Position

The intake coordinator serves as a support to health plan teams by completing administrative tasks and coordinating activities such as answering telephones, taking messages and answering routine questions. In addition, composes, types and distributes meeting notes, routine correspondence, presentations, billing, reimbursement or monthly reports. May maintain master copies of company policy and procedure manuals, keeping them up-to-date. Manages all mailings to members and responsible for necessary correspondence. Documents all member/provider interaction in member database software per expected workflow. Strong verbal and written skills geared toward communicating by phone, in writing and in person. Must project a positive and professional image. Must be able to interact compassionately with members on a one-on-one basis and anticipate their needs through careful listening and patience. Must be highly organized and able to handle multiple tasks under constant pressure. Microsoft Office skills are required. Awareness of when and how to access additional resources to meet needs of members. For individuals supporting clinical areas, additional duties are: Utilization management performs resource benefit policy management, triages inbound and outbound calls, processes intake requests (prior authorizations), completes data entry and assigns cases to appropriate clinical team members. Supports medical management programs and operations. Case management leads the initial intake and review of members who are eligible for medical and behavioral health case management services. Assigns members to team based on risk score and clinical rules. Provides support to case managers by scheduling telephonic visits with members, completing initial clinical screening questionnaire of members, facilitating correspondence with members including educational materials and other resources. Reviews Sanford Health Plan member risk score reports. For individuals supporting non-clinical areas, additional duties may include but not limited to: tracking metrics/dashboards; files details from workshops, events or other assigned functions with CMS and provides compliant materials specific to the event. Manages correspondence/communications with potential clients/customers and routes prospect calls for assistance. Schedules meetings and calls for assigned staff members when needed. Coordinates with Marketing for event mailings.

Requirements

• High school diploma or equivalent preferred.
• Two years in a business or health care setting with strong emphasis on customer service and handling confidential matters.
• Microsoft Office skills are required.
• Strong verbal and written skills geared toward communicating by phone, in writing and in person.
• Must project a positive and professional image.
• Must be able to interact compassionately with members on a one-on-one basis and anticipate their needs through careful listening and patience.
• Must be highly organized and able to handle multiple tasks under constant pressure.
• Awareness of when and how to access additional resources to meet needs of members.

Nice To Haves

• Associate degree preferred.
• Health system experience preferred.
• May require a valid driver’s license and maintain a good driving record.

Responsibilities

• Manages all mailings to members and responsible for necessary correspondence.
• Documents all member/provider interaction in member database software per expected workflow.
• Utilization management performs resource benefit policy management, triages inbound and outbound calls, processes intake requests (prior authorizations), completes data entry and assigns cases to appropriate clinical team members.
• Supports medical management programs and operations.
• Case management leads the initial intake and review of members who are eligible for medical and behavioral health case management services.
• Assigns members to team based on risk score and clinical rules.
• Provides support to case managers by scheduling telephonic visits with members, completing initial clinical screening questionnaire of members, facilitating correspondence with members including educational materials and other resources.
• Reviews Sanford Health Plan member risk score reports.
• Tracking metrics/dashboards.
• Files details from workshops, events or other assigned functions with CMS and provides compliant materials specific to the event.
• Manages correspondence/communications with potential clients/customers and routes prospect calls for assistance.
• Schedules meetings and calls for assigned staff members when needed.
• Coordinates with Marketing for event mailings.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees