Clinical Coordinator: Utilization Management

Devoted Health

Devoted Health

Remote · Arizona, USA
Posted on Saturday, April 6, 2024

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Job Description

A bit about this role:

The Clinical Coordinator has an important role supporting Clinical Operations as we ensure our members have appropriate post discharge planning and follow up in place. The Clinical Coordinator will support the team with member outreach and coordination while the member is inpatient and post discharge.

Responsibilities will include:

  • Reaching out to hospitals and provider offices to obtain clinical documentation

  • Reaching out to Home Care and DME vendors to confirm start of care

  • Reviewing member charts in the clinical documentation system for claim adjudication and updating associated episodes as needed

  • Monitoring return fax que and researching provider profile for updated contact and fax information

  • Monitor intake que and assign new referrals to nurse census

  • Provide additional operational support for assigned team and manager as designated

  • Pull medical record from hospital EHR access

  • Help with discharge planning

  • Help RN with Cases

  • Provide additional operational support for assigned team and manager as needed

  • Outreach Member when admitted to Post Acute facility and complete a Welcome call.

  • Outreach to Post Acute facilities to confirm Member admission date.

  • Work with Looker to download your daily assignments and reports.

  • Work with inpatient tool for RFIs

  • Assist with the observation workflow

Attributes to success:

  • Things move swiftly at a startup - enjoying a fast paced environment is key

  • Understanding urgency and having the ability to juggle multiple priorities

  • You follow up relentlessly

  • You can see the process and ways to make it better

  • Ability & agility to multitask - you may be asked to do several things and need to change plans mid day

  • You’re a great team player with a can do attitude

  • Great communication skills - you’ll be talking and emailing with a lot of different stakeholders

  • Candidate will need to be available to work varying hours between 8am EST to 8pm EST

Desired skills and experience:

  • A high school diploma - Required

  • Managed Care / Health Plan experience preferred

  • 1-3 years of administrative or Medical Office experience preferable

  • Proficient in technology - Google Sheets and suite of google products- Strongly Preferred

  • Proficient navigating EHR and Clinical Documentation Systems

  • Remote work

  • Bilingual a plus

Salary Range: $22.50 - $26 per hour

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.