For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)
The Dental Fair Hearing Coordinator will help administratively support the UnitedHealthcare Dental Texas Medicaid and CHIP Programs by leading all fair hearing activities from initial contact through final resolution. As a support to the A&G team, the Fair Hearing Coordinator will have overall responsibility for facilitating receipt and submission of member Fair Hearing requests to HHSC in support of oral health and wellness.
If you are located in Texas, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:
- Retrieve and process fair hearing requests in timely manner
- Engage members as needed to facilitate Fair Hearing request
- Effectively liaison between the plan, members, TX HHSC and delegated vendors.
- Ensure proper documentation of Fair Hearing status and outcomes
- Prepare evidence packet and coordinate review of the evidence packet
- Attend Fair Hearing. Represent UHC Dental for administrative Fair Hearing cases
- Process and Implement Fair Hearing decision
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
- 2+ years of experience with Texas Managed care programs
- Knowledge of Texas Medicaid and CHIP members' right to appeal and request a Fair hearing for adverse determinations
- Proficiency in working with MS Word, Excel, SharePoint and Outlook
- Excellent oral and written communication skills
- Excellent organizational skills
- Ability to handle confidential aspects of the position
- Ability to lead, work independently and effectively navigate matrixed organization.
- Good analytical abilities
Careers with UnitedHealthcare.
- Knowledge of Fair Hearing process
- Telephonic and / or call center experience
- Experience with working with all levels of leadership
- Bachelor's Degree; or equivalent combination of education and experience.
- Bilingual in Spanish
Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work. (sm)
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Dental, Case Manager, Managed Medicaid, Medicare, Commercial Care , community resources Telecommute, Telecommuter, Work from home, Remote
Location/Region: San Antonio, TX