Opportunities with American Health Network , part of Optum. When you join American Health Network (AHN), you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. At American Health Network, we want to be the best health care organization we can be. Our mission is to improve the health of our patients. We’re a physician-led organization, operating over 70 medical offices in Indiana and Ohio, with over 300 providers and 1200 employees. We’re also part of Optum, in the UnitedHealth Group family of businesses, and backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. That’s an important differentiator as more people need our help simplifying the complexities of the American health care system. At the same time, the culture of AHN supports work-life flexibility for employees and places a high value on their physical, emotional, financial and other aspects of well-being. Find out what it means to be part of an exceptional company that values its employees, its role in health care, and making a difference one patient at a time. Take a look at American Health Network and explore a new path to your life’s best work.(sm)

Location: This role is fully remote, but candidates should live in the Ohio area

Schedule: Monday-Friday Hours ranging from 8:00-5:00

Specialty: Care Management

If you are located in Ohio, you will have the flexibility to work remotely* as you take on some tough challenges

Primary Responsibilities:

• Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations
• Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g., phone queue, CM/UM electronic platform, portal, department e-mail box or Rightfax
• Coordinates and assists in monitoring of documentation Care Management queues for Disease Management, Transitions of Care, Complex Care, and Social Work referrals
• CTA processes CM requests via all communication venues; as well as administrative preparation for clinical staff
• Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members
• Performs daily preparation of INPT and Post-Acute Census for use in CM referrals, and informs Care Management Manager of outstanding cases to ensure adherence to NCQA regulations
• Completes timely data entry of in-bound and/or out-bound call member contact information into software applications
• Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
• Provides excellent customer service by serving as a resource to all internal and external customers
• Attends required meetings and participates in adhoc committees as needed
• Maintains knowledge of all health plan benefits, network, NCQA regulations, health plan policies
• Identifies opportunities for process improvement in all aspects of patient care
  

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma or GED equivalent
• 2+ years of administrative or clinical experience in healthcare
• Medical terminology knowledge base
• Proficiency in Excel
• Reside in Ohio
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
  

Preferred Qualifications:

• Care management and/or medical assistant experience
• EMR / EHR experience
  

Unless certification, licensure or registration is required, an equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed in this description, may be substituted for the above requirements.

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.