Northern Light Mayo Hospital
Department: Physician Practice Central Ops
Position is located: Medical Office Bldg- Dover Foxcroft
Work Type: Full Time
Hours Per Week: 40.00
Work Schedule: Variable
Summary:
Responsible for facilitating the management of requested medical services for appropriate utilizatoin of resources, by evaluating order requests for eligibility, benefit determination, preferred provider networks, level of care and medical necissity. In conjunction with the Medical Director, Nurse Case Manager and Managmeent Team.
Responsibilities:
- Takes and records messages when a staff member is unable to take the call personally.
- Promptly answers telephone calls in a courteous manner. Excercises considerable judgment and tact to ascertain the caller's needs.
- Facilitates the management of requested medical services for appropriate utilization of resources.
- Evaluates order requests for eligibility, benefit determination, preferred provider networks, level of care and medical necessity. In conjunction with the Medical Director, Nurse Case Manager and Management Team.
- Works as part of a team dedicated to maximizing office visits and assuring adequate access for the people we serve.
Other Information:
Competencies and Skills
- Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.
- Applies Business Acumen:Demonstrates knowledge of current and future trends that impact organizational success. Applies proven practices and business theories to get results that meet financial as well as other business goals. Recognizes opportunities for new services and products and acts accordingly, taking measured risks into consideration. Possesses a thorough knowledge of their field and independently carries out their work in accordance with professional standards of the profession.
- Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
- Influences and Inspires: Builds enthusiasm and commitment among others to move in a desired direction and models it personally. Creates a compelling vision of success that motivates workplace initiative and energizes others to follow. Provides direction and guidance to encourage cooperation between team members in order to attain an objective. Has the ability to appropriately influence others' actions and decisions with and without express authority.
- Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources. As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time.
- Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
- Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.
- Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
- Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.
Education
- Required High School Diploma/General Educational Development (GED)
Required Experience
- 1 year/years of Relevant Work Experience
Working Conditions
- Potential exposure to diseases or infections.
- Work with computers, typing, reading or writing.
- Lifting, moving and loading 20 to 30 pounds.
- Prolonged periods of sitting.
- Prolonged periods of standing.