Description

Job Summary:

Provides timely and high quality administrative and/or project support for the Departments of QRM with dedicated support to the following areas: (1) Readmission / Transitional Care team and the Specialty Review Team (2) Obtains hospital discharge summaries for core and non - core hospitals (3) Post discharge calls to members. Responsibilities may include answering phones and relaying messages/information to both departmental staff and callers; scheduling patient appointments; maintaining filing systems; data entry; opening/sorting mail. Requesting clinical info from Noncore, SNF/Rehab facilities to ensure timely concurrent review, assist in arranging non-urgent transportation for members in SNF/Rehab facilities.

Essential Responsibilities:

This description is for recruitment posting purposes only. It has not received full HR review and approval.
- Obtains Hospital Discharge Summaries and sends to medical records to be filed in members electronic medical record.
- Provides support to the Telephonic Inpatient Care Coordinators, the SNF/Rehab Care Coordinators and the Transitional Case Manager as outlined above.
- Responsible for the concurrent review right fax pool.
- Responsible for the generation of NONC and denial letters with proofing done by the General Review Supervisor.
- Schedules follow up appointments for members upon request.
- Maintains a filing system for copies of all NONC and denial letters for utilization review and quality assurance purposes.
- Maintain Transplant Log/files and obtains the check for transplant members.
- Provides administrative duties such as typing correspondence and answering telephones on a as needed basis for the QRM department.
- Remains knowledgeable of contract benefits and current, relevant state and Federal regulations.
- Maintains effective interaction/communication with members of the medical staff, nursing staff, other QRM staff, and Kaiser Permanente medical offices.
- Builds effective working relationships with physicians/staff, QRM staff, and other departments within the health plan.
- Identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate.
- Maintains member confidentiality.
- Supports QRM Management team.
- Assists with telephone pound-out calls for the Transitional Case Review and General Review Nurses.
- Type's letters, memos, minutes and reports utilizing word processing equipment.
- Makes copies and distributes accordingly.
- Assists with mass mailings and special projects to include making copies, collecting materials and distribution of same.
- Assumes responsibilities of the QRM Administrative Coordinator their absence.
- Performs related miscellaneous duties as required by the position and as directed by the directors of Provider Contracting and QRM.

Basic Qualifications:

Experience

Experience
- Three (3) years in an administrative coordinator role.
- One (1) year of database experience.
Education

• - AA degree.

License, Certification, Registration

• N/A

Additional Requirements:

• - Excellent written and oral communication skills
• - Ability to work effectively in a team environment. Must be team oriented.
• - Strong computer skills including Email and Calendar systems, Microsoft Office, Word, Excel, Power Point, Visio and Access.
• - Strong organizational skills, critical problem solver, planning abilities and attention to detail. Must be able to prioritize
• - Must be able to tolerate a confidential environment and the implications of confidentiality.
• - Proficient in Excel.

Preferred Qualifications:

• - Previous Referral Coordinator experience or Health care administrative experience preferred.
• - Customer service aptitude demonstrated through Customer Service Assessment preferred.

Primary Location: Georgia,Atlanta,Regional Office - 9 Piedmont
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun
Working Hours Start: 08:30 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: GTC|UFCW|Local 1996
Job Level: Entry Level
Department: Regional Office - 9 Piedmont - Centralized O/S Utility Mgmt - 2808
Pay Range: $22.72 - $28.51 / hour Travel: Yes, 15 % of the Time On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
Requisition #: 1405617

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