Responsibilities Case Manager (Bachelor) is responsible for registering health care services and for referring clients to the appropriate level of care after consulting with the Clinical Manager, Clinical Supervisor, Director, or Psychiatrist. Records the services authorization and complies with the established processes to coordinate services with the providers. Educates clients, their representatives and their dependents about the coverage benefits available and about community resources. Responsibilities and essential duties: Answers the telephone in the company’s established time frame, with a clear and pleasant tone of voice, and with an appropriate language expression. Upon answering the telephone, FHC Call Center staff identify themselves by name, title, and organization’s name. Shows appropriate communication skills, effective listening, and management skills to deal with difficult clients. Conducts telephone interview to gather the necessary data, logs the health care services, coordinates appointments, makes the referrals, and service authorizations. Educates the insured about our programs and coverage’s benefits. Verifies the member eligibility before processing and logging the phone call in the program. Complies with the guidelines and established criteria for the different processes. Demonstrate knowledge when using the program to log the health care services and the other technological applications available. Register the phone calls received in the appropriate platform. Conducts with the interview process and documents according to the requirements of the Health Insurance Portability and Accountability Act (HIPAA) and law 408. Applies in a consistent manner the policies and procedures that are pertinent to the Access Center at FHC Complies with the established quality parameters, abandonment rate and average speed of answer. Interacts with members of the Integrated System to guarantee the efficiency and continuity of service. Manages the emergency calls according to the standard procedures established in the practice of mental health services and according to the internal policies and procedures established by the organization, which are relevant to the Access Center. 15. Participates in the mandatory trainings, such as: the Annual Compliance Plan, Human Resources & Departmental, URAC, NCQA and CMS guidelines. Complies with the established attendance and punctuality policies. Agree to comply with the following requirements, but not limited to: Code of Conduct, Ethics, Confidentiality, Conflict of Interest, etc. Complies with the standards of the Service Excellence Program. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449 Qualifications Bachelor of Psychology, Social Work, or Social Sciences. Relevant work experience: Not experience required. Knowledge in Microsoft Office Preferable fully bilingual Available to work 24/7 rotating shifts schedule
Bachelor of Psychology, Social Work, or Social Sciences. Relevant work experience: Not experience required. Knowledge in Microsoft Office Preferable fully bilingual Available to work 24/7 rotating shifts schedule
Case Manager (Bachelor) is responsible for registering health care services and for referring clients to the appropriate level of care after consulting with the Clinical Manager, Clinical Supervisor, Director, or Psychiatrist. Records the services authorization and complies with the established processes to coordinate services with the providers. Educates clients, their representatives and their dependents about the coverage benefits available and about community resources. Responsibilities and essential duties: Answers the telephone in the company’s established time frame, with a clear and pleasant tone of voice, and with an appropriate language expression. Upon answering the telephone, FHC Call Center staff identify themselves by name, title, and organization’s name. Shows appropriate communication skills, effective listening, and management skills to deal with difficult clients. Conducts telephone interview to gather the necessary data, logs the health care services, coordinates appointments, makes the referrals, and service authorizations. Educates the insured about our programs and coverage’s benefits. Verifies the member eligibility before processing and logging the phone call in the program. Complies with the guidelines and established criteria for the different processes. Demonstrate knowledge when using the program to log the health care services and the other technological applications available. Register the phone calls received in the appropriate platform. Conducts with the interview process and documents according to the requirements of the Health Insurance Portability and Accountability Act (HIPAA) and law 408. Applies in a consistent manner the policies and procedures that are pertinent to the Access Center at FHC Complies with the established quality parameters, abandonment rate and average speed of answer. Interacts with members of the Integrated System to guarantee the efficiency and continuity of service. Manages the emergency calls according to the standard procedures established in the practice of mental health services and according to the internal policies and procedures established by the organization, which are relevant to the Access Center. 15. Participates in the mandatory trainings, such as: the Annual Compliance Plan, Human Resources & Departmental, URAC, NCQA and CMS guidelines. Complies with the established attendance and punctuality policies. Agree to comply with the following requirements, but not limited to: Code of Conduct, Ethics, Confidentiality, Conflict of Interest, etc. Complies with the standards of the Service Excellence Program. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449