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UnitedHealth Group Clinical Triage Analyst - Phoenix, AZ in Phoenix, Arizona

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

The Clinical Triage Analyst is responsible for addressing administrative aspects of quality of care investigations.

Primary Responsibilities:

  • Opening quality of care referrals in E-file and quality of care data base

  • Monitoring and maintaining the integrity of the quality of care E-files and quality of care data base

  • Communicating both written and verbally to care providers, regulatory agencies, and internal departments

  • Responding to regulatory referrals within mandated timeframes

  • Obtain required documentation from EMR for quality of care investigations

  • Conducting internet searches, literature reviews and other resources for standards of care, best practices

  • Summarize quality of care concerns and identify medical records and/or responses required to address concerns

  • Access various applications to obtains claims, case management, member eligibility and other pertinent information for quality of care investigations.

  • Identification of potential imminent threat to member safety and referral as appropriate

  • Support Clinical Quality RN functions

  • Maintain department spreadsheets for tracking and trending

  • Managing quality of care referrals from various sources

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 2+ years experience with medical terminology in a healthcare setting

  • 2+ years experience with Microsoft Word (work within templates), Microsoft Excel (reporting, data entry and sort, filter) and Microsoft PowerPoint ( creating slides)

  • 2+ years experience with database management

Preferred Qualifications:

  • Associate Degree (or higher)

  • Licensed Practical Nurse/Licensed Vocational Nurse certification

  • Project management experience

Physical Requirements and Work Environment:

  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer

  • Office cubicle environment with moderate noise level due to team members talking, computers, printers and floor activity

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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.

Keywords: UHC AZ IDD 2019 , Phoenix, AZ, Triage, Healthcare, Medical Terminology