Help design and build a health plan from the ground up as an Intake Coordinator. Reporting to the Health Plan Manager of Utilization Review, the Intake Coordinator will be an integral member of the health plan’s medical management team. This team member will serve as the point-person for all inbound requests for utilization review from providers and pharmacies. The Intake Coordinator will utilize technology to push data to internal stakeholders for decision making.
The Intake Coordinator is a collaborative member of the Medical Management team
MINIMUM QUALIFICATIONS
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School diploma or equivalent with One (1) year of of working in healthcare AND One (1) year of customer service experience.
OR
Bachelors degree.
PREFERRED QUALIFICATIONS
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Associate Degree in related healthcare field.
EXPERIENCE:
1.Two (2) plus years of healthcare and customer service experience.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Obtains requests from providers via phone, fax, or provider portal.
2. Understands and utilizes software systems to determine member plans and requirements.
3. Builds the case in the utilization management system.
4. Determines cases that may require additional notification to the member, provider and/or pharmacist. When needed, contact the member or provider by phone to obtain the information.
5. Ensures accuracy of data entry to prevent downstream errors.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Standard office environment
SKILLS AND ABILITIES:
1. Excellent written and oral communication
2. Problem solving capabilities to drive improved efficiencies and customer satisfaction
3. Attention to detail
4. Proficiency with Microsoft Office
Additional Job Description:
Scheduled Weekly Hours:
40
Shift:
Exempt/Non-Exempt:
United States of America (Non-Exempt)
Company:
PHH Peak Health Holdings
Cost Center:
2403 PHH Medical Management
The West Virginia University Health System, which operates under the brand WVU Medicine, is West Virginia’s largest health system and the state’s largest employer with more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues. The Health System is comprised of 25 hospitals – including J.W. Ruby Memorial Hospital, an 880-bed academic medical center, and the 150-bed WVU Medicine Golisano Children’s Hospital in Morgantown, West Virginia – and five institutes. To learn more, visit WVUMedicine.org.
