Careers At UNM Medical Group

Population Health - Care Coordinator

Department: Population Health Management
Location: Albuquerque, NM

UNM Medical Group, Inc. is hiring for a Care Coordinator to join our Population Health team! This opportunity is a full-time day shift opening located in Albuquerque, New Mexico.

The Population Health Care Coordination team currently consists of three care coordinators who pride themselves on providing excellent customer service to our self-funded medical benefit participants and health system patients.

The successful incumbent must have the ability to work independently in a contact center environment with strong critical thinking skills, effectively assist the needs of the customers and patients we serve, and willingness to adapt to changing priorities.

This ideal candidate is detail-oriented, has strong written and verbal communication skills, and handles sensitive information with discretion and confidentiality and the ability to report in office 100% of the time. This is not a hybrid or remote position.

Preference will be given to candidates who have prior contact center experience and/or working in the health plan payer environment.

The Population Health Care Coordinator performs data informed patient outreach to close gaps in care and improve patient outcomes for UNM Health System patients. They will also provide direct customer service to health plan participants and providers through care coordination, referral management, appointment scheduling, prior authorizations, claims, and billing inquiries, as appropriate. 

 

Summary

The Population Health Care Coordinator performs data informed patient outreach to close gaps in care and improve patient outcomes for UNM Health System patients. They will also provide direct customer service to health plan participants and providers through care coordination, referral management, appointment scheduling, prior authorizations, claims, and billing inquiries, as appropriate. 

 

Minimum Job Requirements of a Care Coordinator: 

High school diploma or GED with at least 4 years of experience related to the duties and responsibilities specified. Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis

Verification of education and licensure (if applicable) will be required if selected for hire.

 

Duties and Responsibilities of a Care Coordinator:

  1. Perform attribution, quality, and scheduling outreach.
  2. Aid UNM Health System Primary Care Clinics with gaps in care closures for value-based contracts and quality reporting.
  3. Communicate patient needs to clinical staff to facilitate positive patient outcomes and experience.
  4. Review outreach reports, validate content, and provide feedback to improve future outreach efforts.
  5. Assist in attribution updates between health system, patient, and MCOs.
  6. Assist in scheduling diagnostic tests per primary care standing orders.
  7. Collaborate with Panel Management to maintain panel integrity.
  8. Perform chart reviews prior to outreach to ensure familiarity with the patient's medical needs and confirm appropriate outreach. Assist in the development implementation, and documentation of, programs, and projects to accomplish department goals.
  9. Research customer complaints/inquiries, facilitate resolutions, and document encounters; provide plan information and assistance to members to ensure maximum coverage and benefit reimbursement.
  10. Verify coverage; obtain medical record information; assign CPT, ICD 10, and HCPCS codes as needed for a predetermination, preauthorization, and/or utilization review; complete and submit required forms for review; document in the appropriate software.
  11. Facilitate and coordinate acute care, primary care, specialty appointments, referrals, and medical equipment, etc., perform follow-up communication with members or designees as needed..
  12. Performs miscellaneous job-related duties as assigned.

 

About UNM Medical Group, Inc.

UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNMMG is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG strives to mitigate health disparities brought about by technology; we aim to reach underrepresented populations, making healthcare more equitable and accessible for all of the people in New Mexico; we have a demonstrated commitment to diversity, equity, inclusion, and student success as well as working with broadly diverse communities.

 

About UNM Population Health Management:

The Office of Population Health Management supports the Health System's transition to value-based care and ensures regulatory compliance. We use data analytics to improve care delivery throughout the UNM Health System. Our team works collaboratively with multiple stakeholders to improve access, utilization, and outcomes for our patients. 

The Office of Population Health Management strives to achieve the Quadruple Aim through:? 
1.Oversight of Value-Based Contracts and related ambulatory quality measures 
2.Proactive preventative care outreach and care coordination 
3.Compliance with Federal Quality Programs? 
4.Implementation of population health technical solutions and workflows 
5.Data driven quality improvement and reporting 
6.Being thoughtful, creative, and good to each other 

 

Benefits:

UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, generous paid time off plan and 403b retirement for benefits eligible employees.

 

Apply to our Population Health Care Coordinator opportunity with UNM Medical Group, Inc. and a recruiter will contact you shortly!

Notice of Equal Opportunity Employment

We are an equal opportunity employer/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, marital status, disability, protected veteran status, or any other characteristic protected by law. We are a drug and alcohol free employer.

We are committed to providing reasonable accommodations to individuals with disabilities in the employment application process. If you need an accommodation due to disability to use our online system to apply with the UNM Medical Group, send an email to accommodations@unmmg.org.

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