Skip to main content

Utilization Management Mail Print Specialist - Texas STAR Kids

Primary Location: Dallas, TX
Additional Locations: TX-Dallas, TX-Ennis, TX-Grand Prairie, TX-Greenville, TX-Irving, TX-McKinney, TX-Plano, TX-Terrell
Apply
Description:
At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas STAR Kids members. We value diversity and are dedicated to helping you achieve your career goals.

The Utilization Management (UM) Mail Support Specialist supports comprehensive coordination of medical services including: receiving, sorting, printing and generating incoming letters; processes and sends outgoing letters according to established procedures to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services. This is an office-based position in the Dallas office.

Fundamental Components:
  • Performs print, seal, stamp and mailing of all document requests generate by UM team. Utilizes Aetna system to research and retrieve letter information.
  • Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
  • Promotes communication, both internally and externally to enhance effectiveness of medical management services
  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
  • Strong attention to detail is required to communicate accurate and detailed specifications to printers.
  • Provide expertise on all aspects of print production including cost and time saving measures and quality assurance.
  • Track all workflow operations via a shared departmental database.
  • Research for missing and/or insufficient information. Maintain production and department records.
  • Communicate with Aetna Case Managers, Prior Authorization and Concurrent Review Nurses and Letter Writers for clarification of information when processing letters and materials.
  • Uses Aetna Systems such as QNXT, Dynamo, Krames, and iNotify. Sedentary work involving significant periods of sitting, walking, standing and printing.
  • Work requires visual acuity to perform close inspection of written and computer-generated documents as well as a PC monitor. Working environment includes typical office conditions.
  • Ensures data integrity by correctly reviewing data and reporting any identified discrepancies to a supervisor.
  • Gathers, sorts and tracks information as requested to meet daily business needs.
  • Identifies and promptly reports any system issues to supervisor for resolution.


Background Experience:
  • 2-4 years experience as a medical assistant, office assistant or other clinical experience.
  • High School Diploma or G.E.D.
  • Effective communication, telephonic and organization skills.
  • Familiarity with basic medical terminology and concepts used in care management.
  • Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
  • Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel. Strong keyboard and mouse skills required.
  • Ability to effectively participate in a multi-disciplinary team including internal and external participants.
  • Pediatric/adolescent experience is preferred
To view all open Texas Star Kids positions please visit: Texas Star Kids


Additional Job Information:
Effective communication, telephonic and organization skills.Familiarity with basic medical terminology and concepts used in care management.Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.Ability to effectively participate in a multi-disciplinary team including internal and external participants.

Clinical Licensure:
N/A

Potential Telework Position:
No

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Apply

Jobs for you

Recently Viewed Jobs

You do not have any recently viewed jobs

Your Saved Jobs

You do not have any saved jobs

Sign up for Job Alerts

Join our Talent Community

At Aetna, a CVS Health Company, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna, a CVS Health Company.

Join Our Talent Community

Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna, a CVS Health Company.