Program Coordinator I

Local Jobs Centene Corporation
  • United States, San Rafael, CA 94901 View on Map
  • Post Date: June 18, 2020
  • Apply Before : July 18, 2020
  • Share:

Job Description

    Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.
  • Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.
  • Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.
  • Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
  • Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.
  • Data enter assessments and authorizations into the system.
  • Education/Experience: High school diploma or equivalent. 2-3 years managed care or physician’s office experience. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. Knowledge of medical terminology.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

 

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Earn rewards for answering questions on products you already used and love.

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Remote: Office Not Required

For too long our lives have been dominated by the ‘under one roof’ Industrial Revolution model of work. That era is now over. There is no longer a reason for the daily roll call, of the need to be seen with your butt on your seat in the office. The technology to work remotely and to avoid the daily grind of commuting and meetings has finally come of age, and bestselling authors Jason Fried and David Heinemeier Hansson are the masters of making it work at tech company 37signals. Remote working is the future – and it is rushing towards us.

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Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

If your dream job is not related to a location, an office or a cubicle farm, then this book is for you. Look at a job in a totally new way and start enjoying life while being more productive.

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Program Coordinator I

Local Jobs Centene Corporation
  • United States, Austin, TX View on Map
  • Post Date: June 4, 2020
  • Apply Before : July 4, 2020
  • Share:

Job Description

    Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.
  • Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.
  • Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.
  • Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
  • Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.
  • Data enter assessments and authorizations into the system.
  • Education/Experience: High school diploma or equivalent. 2-3 years managed care or physician’s office experience. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. Knowledge of medical terminology.


    Preferred Experience:
  • 3 + years of experience with client/member services and providing health screenings via outbound calls
  • Professional phone etiquette and listening skills
  • Proficient with Microsoft Excel
  • Bilingual capabilities is a plus – Spanish preferred.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

 

“How to Find a Job” Books

We may earn a commission if you click on some of the links below and make a purchase at no additional cost to you.


How to Find a Job Books

Finding A Remote Job A Complete Guide – 2020 Edition

Finding A Remote Job A Complete Guide - 2020 Edition

Do you have the right kind of job? How should implementation be staged? Where are you prepared to go for a job? What are the main goals of your job club? Is building culture possible with a remote team?

Defining, designing, creating, and implementing a process to solve a challenge or meet an objective is the most valuable role… In EVERY group, company, organization and department.

VIEW BOOK


Breakthrough Remote Job: Earn rewards for answering questions on products you already used and love. Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

Breakthrough Remote Job: Earn rewards for answering questions on products you already used and love. Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

Earn rewards for answering questions on products you already used and love.

Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

I earn weekly for helping WordPress customers with their problems. My job is to reply emails, chat customers and answer questions, most of which we already have answers to in our HUB and forum.

You can join too as it is available to anyone of any age worldwide.

VIEW BOOK


Remote: Office Not Required

Remote: Office Not Required

For too long our lives have been dominated by the ‘under one roof’ Industrial Revolution model of work. That era is now over. There is no longer a reason for the daily roll call, of the need to be seen with your butt on your seat in the office. The technology to work remotely and to avoid the daily grind of commuting and meetings has finally come of age, and bestselling authors Jason Fried and David Heinemeier Hansson are the masters of making it work at tech company 37signals. Remote working is the future – and it is rushing towards us.

VIEW BOOK


Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

If your dream job is not related to a location, an office or a cubicle farm, then this book is for you. Look at a job in a totally new way and start enjoying life while being more productive.

Employers will like this book and embrace working-from-anywhere to have more engaged employees, attract top talent and save big on the bottom line.

VIEW BOOK


Read More

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