TCSS Coordinator (Part-Time)
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POST DATE 8/8/2016
END DATE 11/1/2016
Oahu Corporate Office
JOB DESCRIPTIONAPPLY The Company
AlohaCare is a local, non-profit health plan which provides comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. In the true spirit of Aloha, AlohaCare supports, cares and serves the health care needs of Hawaii's residents and specializes in care for the medically underserved and medically fragile. As Hawaii's third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.
AlohaCare employees share a passion for helping Hawaii's most underserved communities. We are committed to serving our members, providers and the larger community as a unifying force for health and health care. This is achieved through the embodiment of the aloha spirit. 'Aloha' is an inclusive, embracing and caring philosophy of life that accepts differences and guides personal interaction towards 'pono' - goodness, excellence and wellness.
AlohaCare's leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare's strong commitment to support local Hawaiian families is practiced with our employees by reinforcing a healthy work/home balance. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, monthly appreciation events, quarterly all-staff meetings and annual galas. AlohaCare's comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.
The Opportunity - Position Summary
The TCSS Coordinator is responsible to facilitate the initial intake and processing of travel/clinical authorization requests (RAN). Coordinates with clinical reviewers (Nurse or Medical Director) to ensure plan guidelines and required authorization turnaround times are met. Coordinates a varied workload and provides administrative support in the most efficient, accurate, and professional manner possible. Position requires the use of judgment and initiative to determine approach or action for necessary non-routine situations.
Primary Duties & Responsibilities:
- Review and distribute incoming RAN's to appropriate folders. Ensure completion of RAN information/documentation needed for appropriate coordination process.
- Respond to requests by providers and members for the authorization of transportation services
- Verify appropriate information is completed on request:
- Confirm member eligibility
- Contact Provider's office to gather additional member information (if applicable) to complete request, which may include apt. / check-in time, location, companions, etc.
- Input authorized requested services and assign authorization numbers according to plan guidelines.
- Document in the Authorization Information System any update(s) or change(s) made on travel needs resulting from outreach calls/contacts.
- Ability to organize, prioritize, communicate and manage workload effectively and efficiently
- Communicate professionally with external and internal consumers regarding travel and clinical prior authorizations
- Provide travel information to member, providers and referring internal Clinician for cases referred internally.
- Submit travel logs to cab companies twice a day and as needed.
- Assist with preparation, tracking and maintenance of reports necessary to carry out the functions of the department. Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment
- Communicate regularly with direct report, other managers and other designated contacts within the organization.
- Perform other duties and responsibilities, as assigned.
AlohaCare recognizes an