Clinical Administrative Coordinator - New York

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Clinical Administrative Coordinator is an integral member of the NY MAP (New York Medicaid Advantage Plus) & NYLTSS (New York Long Term Services and Supports) clinical team, providing the administrative support necessary to ensure that enrollees and members receive their Long-Term Services and Supports (LTSS). Working closely with Care Managers (CMs) and CM Managers, this role serves as a key operational resource - triaging calls, coordinating with LTSS vendors, maintaining accurate clinical documentation, and monitoring eligibility and assessment data in New York State systems. This is a high-volume, service-oriented environment that requires strong organizational skills, attention to detail, and a commitment to excellence in supporting vulnerable Medicaid populations.

This position is full-time (40 hours/week) Monday - Friday from 8:30 AM - 5:00 PM. It may be necessary, given the business need, to work occasional overtime.

If you are in New York state, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

Administrative Support to the Clinical Team

• Serve as an integral administrative partner to the NY MAP & NYLTSS clinical team, providing day-to-day operational support to Care Managers and CM Managers to facilitate seamless delivery of LTSS to members
• Ensure required internal clinical documentation is accurately saved in each member's record; identify and report any documentation gaps or missing records to the appropriate clinical staff in a timely manner
• Review, organize, and disseminate Excel-based reports to CM staff as needed to support care management workflows, caseload monitoring, and compliance tracking

Member & Provider Call Triage and Escalation

• Triage inbound calls and requests from NY MAP & NYLTSS enrollees, family members/caregivers, and LTSS providers, accurately assessing the nature and urgency of each inquiry
• Escalate member and provider issues to the assigned Care Manager or CM Manager in accordance with established NY MAP & NYLTSS protocols, ensuring warm handoffs and complete documentation of the concern
• Document all interactions thoroughly within the care management system, maintaining HIPAA compliance and adherence to NY MAP & NYLTSS record-keeping requirements

LTSS Vendor Coordination & Service Gap Management

• Collaborate with contracted LTSS vendors - including home care agencies, personal care providers, adult day health programs, and other community-based service organizations - to confirm that authorized services are in place and being delivered to members
• Identify and communicate service gaps or initiation delays to the assigned Care Manager for timely resolution, ensuring members do not experience interruptions in their authorized LTSS
• Track and document vendor follow-up activities, maintaining a clear record of service status and outreach efforts within the care management platform

Eligibility & Assessment Review in NYS Systems

• Review member Medicaid eligibility status in New York State systems (e.g., ePACES) and flag any lapses, pending renewals, or changes that may impact LTSS service continuity
• Monitor assessment completion status in NYS systems (e.g., UAS-NY), ensuring that required assessments are current and coordinating with Care Managers when follow-up is needed
• Report eligibility and assessment discrepancies to the clinical team and escalate to the CM Manager as appropriate to maintain compliance with NYSDOH MLTC/MAP & NYLTSS requirements

This is a high-volume, service-oriented environment. You will need to be efficient, productive, and thorough in supporting NY MAP & NYLTSS members and the clinical team. You must be able to work a flexible schedule that may include evening hours. You'll be rewarded and recognized for your performance in an environment that will challenge you, give you clear direction on what it takes to succeed in your role, and provide development opportunities for other roles you may be interested in.

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:

• High School Diploma/GED
• 2+ years of customer service experience
• Intermediate proficiency with Microsoft Word (create, edit, and save documents), Microsoft Excel (create, edit, and save spreadsheets), and Microsoft Outlook (email and calendar management)
• Must reside in New York State
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications:

• Experience working within the health care industry and with health care insurance, particularly in a Medicaid, MLTC, or Managed Care environment
• Familiarity with New York State Medicaid systems including ePACES and UAS-NY
• Experience working with LTSS vendors, home care agencies, or community-based service providers
• Clerical or administrative support background in a clinical or managed care setting
• Knowledge of ICD-10 and CPT codes
• Experience working in a call center or high-volume telephonic environment

Soft Skills:

• Strong organizational and time management skills
• Ability to multi-task and prioritize workload in a fast-paced environment
• Ability to keep all company-sensitive documents and member protected health information (PHI) secure

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment.  We comply with all minimum wage laws as applicable. 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN