Note: The job is a remote job and is open to candidates in USA. UnitedHealthcare is dedicated to simplifying the health care experience and improving community health. The Behavioral Health Triage Analyst will support the Behavioral Health Clinical Quality Analyst team by managing quality of care investigations and maintaining case files in regulatory portals.
Responsibilities
- Create, maintain, and manage confidential electronic investigation files for QOC cases
- Manage case entries, updates, and closures in regulatory IAD portals
- Open, triage, and manage QOC cases within internal databases
- Initiate medical record requests for QOC investigations based on clinical behavioral health team judgment
- Outreach to providers for additional information requests regarding QOC's, CAP's and Systemic
- Assist with management of the UHCCP QOC platform (Pega)
- Collaborate with Behavioral Health Clinical Quality Analysts, QM staff, and cross functional UHCCP departments
- Manage multiple tasks, projects, and changing priorities while prioritizing work products effectively
- Utilize multiple databases for data retrieval and entry, and learn new or complex UHCCP systems as required
Skills
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 1+ years of experience working in a behavioral health hospital, behavioral health facility, or outpatient behavioral health clinic
- Experience with Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
- Intermediate proficiency with Microsoft Word (ability to open, edit, save and send documents)
- Intermediate proficiency with Microsoft Excel (ability to work with multiple data bases to retrieve and enter information)
- Ability to work full-time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work an 8-hour shift schedule during our normal business hours of 7:00 am - 6:00 pm MST
- Active, unrestricted LPN license
- 2+ years of experience working as a Licensed Practical Nurse
- Experience working in a deadline driven environment prioritizing responsibilities
- Knowledge of Behavioral Health Medicare/Medicaid regulations
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Company Overview
UnitedHealthcare helps people live healthier lives by simplifying the health care experience. It was founded in 1977, and is headquartered in Minnetonka, Minnesota, USA, with a workforce of 10001+ employees. Its website is http://www.uhc.com.