Administrative Coordinator - Hybrid Role with Career Growth
Company: Fallon Community Health Plan
Location: Worcester
Posted on: May 15, 2022
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Job Description:
Administrative Coordinator - Hybrid Role with Career
GrowthUS-MA-WorcesterJob ID: 6780Type: Full Time# of Openings:
1Category: Administrative/ClericalFallon Health - Corp
HQOverviewFallon Health Vaccination Requirements:To protect the
health and safety of our workforce, members and communities we
serve, Fallon Health now requires all employees to disclose
COVID-19 vaccination status. As of 2/1/2022, all roles not
designated as "Remote" require full COVID-19 vaccination and Fallon
Health will obtain the necessary information from candidates prior
to employment to ensure compliance. Failure to meet the vaccination
requirement may result in rescission of an employment offer or
termination of employment. About Fallon HealthFounded in 1977,
Fallon Health is a leading health care services organization that
supports the diverse and changing needs of those we serve. In
addition to offering innovative health insurance solutions and a
variety of Medicaid and Medicare products, we excel in creating
unique health care programs and services that provide coordinated,
integrated care for seniors and individuals with complex health
needs. Fallon has consistently ranked among the nation's top health
plans, and is accredited by the National Committee for Quality
Assurance for its HMO, Medicare Advantage and Medicaid products.
For more information, visit fallonhealth.org. Overview:Do you like
to help patients/members but don't want to be on the front lines?
Do you have the organization, communication, administrative and
collaboration skills to help our Care Management Teams assist
Fallon Health members to access and coordinate their care? If yes,
this hybrid (in office and at home) role is for you! Do you have
strong working knowledge of Microsoft products including excel
pivot tables and enjoy working with data and reports? Are you
organized and want to help patients without being on the front
lines? This role is pivotal in performing valuable 'behind the
scenes' functions that support our Care Management Teams. Duties
include but are not limited to: receiving and assigning new members
to our Care Teams, facilitating mailings to members, receiving
incoming medical records and ensuring information is provided to
the correct Care Teams, working in partnership with community
agencies such as the Aging Service Access Points (Elder Service
Agencies) ensuring access to our systems and communication and
managing data and reports. This position performs valuable 'back
office' functions that support and enable the various roles in the
department to outreach and work with member populations.
ResponsibilitiesNew Member Processing and Referral
Functions:Receives incoming member completed health risk assessment
tools including but not limited to Medicare member Care Needs
Screenings, keypunching details in the documentation system and
assigning members for outreach based upon member responses to
trigger questionsReceives incoming member referrals and utilizing
the documentation system to assign member for Care Team outreach in
the various available Clinical Integration Team ProgramReceives
incoming member completed health risk assessment tools including
but not limited to Medicare member Care Needs Screenings,
keypunching details in the documentation system and assigning
members for outreach based upon member responses to trigger
questionsReceives incoming member referrals and utilizing the
documentation system to assign member for Care Team outreach in the
various available Clinical Integration Team ProgramMember Related
Supportive Functions (administrative): Creates NaviCare member
authorizations in the QNXT system for member admissions to long
term care facilities for short term and custodial care Processes
all incoming/outgoing member mail (letters and other approved
materials) generated by the Care Team staff with accuracy Manages
incoming faxes and member specific data, routing to the appropriate
Care Team member Manages the Case Management Referral Phone Line
and generates/facilitates timely referrals to Care Team staff based
upon product and assignment logicManages the Case Management
Referral Phone Line and generates/facilitates timely referrals to
Care Team staff based upon product and assignment logicMember
Related Supportive Functions (detailed and unique to role):Manages
various queues in the TruCare system following established
processes for a variety of workflows. , including but not limited
to the SCO LTC Queue for all NaviCare Short Term Custodial and Long
Term Care admission/discharge/extension related
communicationManages the TruCare 'CM Intake Queue' following
established processes and assigns members to Clinical Integration
Team staff for outreach and actionReceives and processes NaviCare
member address change requests utilizing a centralized mailbox in
Outlook and communicates such to interdepartmental teams via QNXT
Call TrackingTruCare System Access Related Functions - Vendor
Management Functions: Reconciles monthly NaviCare ASAP rosters in
preparation for automated sending and corrects and resends ASAP
rosters when discrepancies are identified maintaining master
rosters on the group driveReporting Related Functions:Obtains the
Daily NaviCare Discharge Report from the Collective Medical Portal,
formats the report to a user-friendly view, saves it in the
appropriate G-drive folder and distributes the report by email to
all staff working on the NaviCare productReceives, manipulates and
distributes monthly Long Term Care Reports to appropriate team
members per current workflows. to support our NaviCare LTC Rating
Category discrepancy file and manipulates and sends to the
appropriate Long Term Care Navigator to work with the facilities
maintaining up to date information on new, closed, and pending
discrepanciesRuns the NaviCare Long Term Care membership report
from Business Objects and manipulates per process and sends to
Senior Accounting Analyst, designated long term care facilities,
and NaviCare Sales Team QualificationsEducation:College degree
preferred; Minimum of high school diploma required Experience:2+
years job experience in an administrative supportive role required.
Experience with medical terminology required. Experience in a
healthcare company required. Demonstrated proficiency including but
not limited to:Use of software programs including but not limited
to Excel, Word, and other computerized systems utilized for
documenting activity and actions including but not limited to
scanning and generating correspondence - ability to type/utilize
keyboard with speed and accuracyAbility to prepare and manipulate
spreadsheets (with or without pivot tables) Effective
collaboration, team work, communication, and change management
skillsAttention to detail and accuracy of work outputAbility to
provide input to step by step process document creation and
updatingAbility to recognize and recommend process changes to
enhance efficiency of output and team productionOther: Satisfactory
Criminal Offender Record Information (CORI) results Fallon Health
provides equal employment opportunities to all employees and
applicants for employment and prohibits discrimination and
harassment of any type without regard to race, color, religion,
age, sex, national origin, disability status, genetics, protected
veteran status, sexual orientation, gender identity or expression,
or any other characteristic protected by federal, state or local
laws. PM16PI177593718
Keywords: Fallon Community Health Plan, Worcester , Administrative Coordinator - Hybrid Role with Career Growth, Administration, Clerical , Worcester, Massachusetts
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