Support the MN, ND, SD Healthplan with fully insured reporting and broker bonus.

-Support 2-50 fully-insured and level-funded new-business from “sold” notification through post-implementation cleanup (90 Days) for UHC MN, ND, SD Commercial Sales Team.-Act as primary liaison with brokers, consultants and employer groups from sold notification onward, supporting installations and collecting, organizing, and submitting sold case paperwork.- Work with internal business partners across the organization to efficiently get groups installed and enrolled with United Healthcare.-Track and log work efforts across a number of systems, organize and provide data entry necessary to successfully support small business sales team.

Manager of Administrative Staff within the Integrated Health Services (IHS) department at PreferredOne. I oversee multiple individuals that span different teams and responsibilities. These teams include:Prior Authorization Intake RepresentativesFront line for incoming PA requests. Intake triages phone calls, faxes, emails and online submission. Work to determine if authorization is needed and what level required (intake review vs. nurse coordinator review). Case Management Enrollment SpecialistsResponsible for member outreach and getting individuals set up with our case and disease management programs. This includes sending member letters, outbound/inbound member calls, and scheduling appointments. They are also the support staff for nurse and social workersUtilization Management Administrative AssistantThis role is the admin support for UM nurse reviewers. Manage and review incoming clinical info, save and document request and triage to appropriate reviewer. Listen to voicemails and dictate information into case note. Call facilities to request clinical for concurrent review.IHS Administrative AssistantProvides Admin support to entire IHS department. Jobs include, but are not limited to: compiling departmental meeting notes, sending satisfaction surveys and compiling results, distribution of incoming mail, sending PA denial letters, and assistance with projects. Duties and Responsibilities-Supervise all center statistics and case loads-Responsible for addressing personnel issues.-Proficient in computer systems and staffs day-to-day work -Identify opportunities for streamlining the use of the systems for documentation-Responsible for completion of quality audits of staff-Conduct 1:1 sessions with staff-Completion of performance evaluations in a timely manner-Conduct team meetings-Delegate special projects /assignments to staff as appropriate.-Serve as back up to other IHS Managers-Assist with identification of high-risk members.

-Supervisor of Integrated Health Services care management enrollment team. This team is responsible for member outreach and getting individuals set up with our case and disease management programs. This includes sending member letters, outbound/inbound member calls, and scheduling appointments. We are also the support staff for nurse and social workers. -Supervisory tasks include but are not limited to: timecards, audits, yearly performance reviews, addressing personnel issues, staff calendars, PTO, monthly staff 1:1’s, monthly staff meetings, implementing new processes and procedures, etc.-Collaborate with CM/CIM supervisors on projects and processes for the department. Provide back supervisory support up to CM/CIM teams.-Delegate new projects and/or reassign projects to staff as needed.-Manage monthly data identification for case management programs: -Uploading and organizations of reports, including coordination with business systems for auto load case building process.-Managing staff case loads.-Track cases opened and report to VP and director.-Create and maintain training documents and departmental processes, including a ‘document management’ work group. Train new employees, including nursing and social work staff, on systems and/or department processes and policies.-Assistance with sending member material including books, pamphlets and other disease specific information.-Track expenses and report to VP and Director (Printing and member resources).-Process Invoices (Printing vendor, Gift card vendor, resource vendors, group specific, and staff member Parking).-Track PreferredOne CEU’s/trainings and provide certificates to staff.-Provide support to outside case management partners. -Manage incentive programs for member.-Review Group application and renewal forms and monitor case management eligibility for groups.-Participation on Committees -Cultural Action Team on improving staff capabilities -Wellbeing committee

-Answering provider and member phone calls.-Setting up medical cases from faxes, online submissions, LOI’s, and phone calls. Approving cases as notification or sending to nurse for review.-Setting up pharmacy cases and approving as notification or sending to nurse for review. After review entering the appropriate override in the PBM system so the pharmacy can process the prescription.-Backup for Supervisor. Distributing caseloads to other intake reps, ensuring work is completed on time and being a contact point for questions or concerns.-Sending out Lack of Information letters from nurse and claim information.-Audits of medical cases. This includes a daily audit of inpatient medical cases and monthly audits of intake medical notifications. -Representative at staff meetings, taking notes, and bringing back information to intake staff.-Supporting customer service, nurses and pharmacy teams with questions, entering overrides for medications, reports, or calling pharmacies to get information.-Assisting Enrollment specialist team with Data entry.-Helping with mail distribution when administrative assistant is out.-Completing customer service training sessions with new CS staff regarding the role of intake within the IHS department.

-Received 2010 Imaging, Pharmacy, Laboratory and Rehabilitation Services Award of Excellence-Received 2008 Rehabilitation Services Support Staff of the Year Award-Checking in and scheduling outpatients for therapy.-Scheduling inpatients for therapy and arranging transport.-Answering and directing phone calls.-Verification of insurance benefits.-Ordering departmental supplies and completing invoices.-Tracking therapy visits and goals for PT, OT, Speech and Wound Clinic patients.