Job description
Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership.
Forbes ranked Premera among America’s 2023 Best Midsize Employers
because we are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
This is a Work From Home Opportunity!
Schedule
This team requires 5 hours each week between 5pm – 7pm PST Monday - Friday or Saturday 9am – 2pm PST (Pacific Standard Time) to provide extended coverage to members.
The Intake Coordinator is responsible to provide the initial outreach, engagement, and screening of members. The intake coordinators educate and assists members in accessing care to close care gaps, utilizing digital resources to support condition self-management, and engage members in case management services. Our intake coordinators support our case management program through specialized assistance including assisting members in accessing centers of excellence (COE) and support the COEs by gathering the member medical records for providers to make determinations, researching complex clinical information, identifying community resources to meet unique member social determinants of health needs, and locating in-network providers (e.g., primary care, specialty, and behavioral health).
Services include answering and managing member, provider and warm transfers to our phone queue, and researching, gathering and analyzing data, writing reports/presentations and presenting findings on a variety of projects that support Clinical Programs.
What you'll do:
What you'll do:
- Provides initial screening of potential complex case management referrals, including screening warm transfers from Customer Service and vendor referrals (e.g., Nurse Line, EAP).
- Works with Case Managers to ensure potential case management referrals are appropriate for the program.
- Researches and provides clinical and complex resource information for case managers and engagement specialists to assist in the management of complex case management cases including maintaining community resource knowledge base.
- Applies nationally accepted criteria to pre-screening members.
- Educates potential candidates for case management regarding the overall case management programs and obtains permission for services, if appropriate.
- Identifies and works to resolve social determinants of health issues that impede proper use of health care services or access to services.
- Informs members of designated programs, gather medical records on behalf of the member and COE
- Research complex clinical information, community resources and locates providers with openings (e.g., residential treatment centers, specialists)
- Ensures documentation is clear, concise and meets all regulatory, legal and accreditation standards.
- Answers calls from members, providers and warm transfers (e.g., Nurse Line, Customer Service) to assist members in accessing care.
- Answers digital member inquiries in our mobile app.
- Triages members (e.g., calls, digital)
- Researches, gathers, and analyzes data; writes reports, including departmental reports such as but not limited operational (e.g., referral source, volume, case assignment), outcome (e.g., satisfaction, clinical), NCQA and quality improvement projects.
- Works collaboratively with providers and support embedded / designated case managers ensuring provider specific reporting (e.g. inpatient notifications, member data, etc.) is provided in a timely manner and ensure accuracy of information shared.
- Identifies emergency department, urgent case and pharmacy utilization concerns and acts to resolve them by working with members, providers, Premera staff and community liaisons as indicated.
- Acts as point person to assist with case management process related questions from internal support staff and customer service.
- Other clinical and administrative duties
What you'll bring:
- Bachelor's degree in social services, human services, behavioral sciences or licensed in allied health field (incumbent located outside Washington State must obtain equivalent WA license within 10 days of accepting the position). (Required)
- 3 years' clinical experience or healthcare experience. (Required)
- Motivational interviewing experience is preferred.
- 5 years clinical experience with patients
- 3 years healthcare experience
- Preferred: Licensed as Licensed Practical Nurse (LPN) or a Certified Counselor (CC)
- Prior Mental Health/Social Work experience
- Prior Medical/Surgical experience
- High Speed Cable, DSL or Fiberoptic Internet, no less than 20 mbps – Satellite and Wireless connections will not work with our equipment. (Required)
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What we offer
- Medical, vision and dental coverage
- Life and disability insurance
- Retirement programs (401K employer match and pension plan)
- Wellness incentives, onsite services, a discount program and more
- Tuition assistance for undergraduate and graduate degrees
- Generous Paid Time Off to reenergize
- Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
National Salary Range:
$48,500.00 - $72,700.00
National Plus Salary Range:
$54,800.00 - $82,200.00
- National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.
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