Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here .

Job Summary

Assist in coordination of workflow for the Medical Clinical Management Team. Work with all members of the Clinical Operations team (which includes Utilization Review, Case Management, Disease Management, Quality Management) helping to support these programs and the department. Respond to provider queries, enter administrative authorization data into the computer system, and maintain proper documentation and files to support care of members, customer service, and other departmental functions.
Enters all referral/data information into the computer system, maintains proper documentation and facilitates coordination of services. The position will be directly associated with incoming referrals and authorizations for the utilization component of medical.
The Intake Coordinator promotes the mission and values of Intake/Outreach Department, Tufts Health Public Plans (THPP) by demonstrating an empathetic and professional demeanor at all times. Available for all Intake/Outreach medical special projects and needs.

Key Responsibilities/Duties – what you will be doing

• Contacts provider offices for further details on referrals, if necessary. Researches member eligibility and primary care selection to complete entry of referral.
• Documents all admissions and referrals. Maintain flow and storage of information such as messages, forms, and logs.
• Assist team personnel with establishing and maintaining efficient communication processes with providers.
• Maintain the flow and storage of information within Intake/Outreach Coordination ensuring it is placed in the appropriate place/registry.
• Maintain and update daily inpatient census.
• Maintain workflow of clearing, sorting and distribution of incoming faxes and authorization requests.
• Data entry of Hospital Admissions, Durable Medical Equipment, Office Visits, Medical Injectables, Referrals, Outpatient Procedures, and various Inpatient and Outpatient requests.
• Prioritize work duties to maintain customer satisfaction through prompt and efficient service.
• Represents Intake/Outreach Coordination at applicable activities including system user groups and other health data system organizations.
• Attends organization-wide meetings and department staff meetings.
• Maintains professional growth and development through self-directed learning activities and involvement in professional, civic and community organizations.
• Exhibits exceptional internal and external customer service skills.
• Ability to work in clinical and company databases.
• Other duties as assigned by the Intake and Outreach Coordination leadership.

Qualifications – what you need to perform the job

• High School degree required or 2-3 years of equivalent experience;
• Associates degree strongly preferred.
• Minimum of 1-year experience working within a managed care, medical or customer service environment.
• Medical terminology and Medicaid experience a plus.
• Knowledge and experience in database software. Intermediate knowledge of Microsoft Office Suite or other similar software applications.
• Exceptional internal and external customer service skills. Ability to multitask.

Salary Range

Compensation & Total Rewards Overview

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.