Healthcare - Case Management Processor

This a Full Remote job, the offer is available from: Washington (USA)

Hours 8-5 PST, Monday - Friday

• Will the position be 100% remote? Yes

• Are there any specific location requirements? Must reside in WA

• Are there are time zone requirements? Member outreach will be in Pacific time, 8 a.m – 5 p.m.

• What are the must have requirements? Excellent communication/customer relation skills; attention to detail; proficiency in documentation; proficient in technology/computer skills

• What are the day to day responsibilities? Outbound calls to Medicaid members to identify medical/BH/Social Determinants of health needs followed by referral/assignment to appropriate team

• Is there specific licensure is required in order to qualify for the role? No

• What is the desired work hours (i.e. 8am – 5pm) 8-5, Monday through Friday

Will require dual monitors and a docking station.

Potential to go perm: I think there is a possibility we may need this position on a permanent basis; however, we need to get caught up first and then see where we are at, through the end of the 6 mos we have the temp staff. If it looks like will need the resource ongoing, I will request a permanent full time position. There just isn't a way to determine that until we get through our backlog.

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)

· Provides support to the Case Management staff performing non clinical activities and supporting the management

of the department.

· Responsible for initial review and triage of Case Management tasks.

· Reviews data to identify principle member needs and works under the direction of the Case Manager to implement

care plan.

· Screens members using Molina policies and processes assisting clinical Case Management staff as they identify

appropriate medical services

· Coordinates required services in accordance with member benefit plan.

· Promotes communication, both internally and externally to enhance effectiveness of case management services

(e.g., health care providers and health care team members).

· Runs reports to assist in coordination of case management needs.

· Provides support services to case management team members by answering telephone calls, taking messages

and researching information.

· Maintains accurate and complete documentation of required information that meets risk management, regulatory,

and accreditation requirements.

· Protects the confidentiality of member information and adheres to company

Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job

satisfactorily)

· Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity

to concerns, proactive identification and resolution of issues to promote positive outcomes for members

· Demonstrated ability to communicate, problem solve, and work effectively with people

· Working knowledge of medical terminology and abbreviations

· Ability to think analytically and to problem solve.

· Good interpersonal/team skills

· Must have a high regard for confidential information

· Ability to work in a fast paced environment

· Able to work independently and as part of a team.

· PC experience in Windows environment and accurate data entry at 40 WPM minimum.

· Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

· Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,

providers and customers

Required Education:

High School Diploma or G.E.D.

Required Experience:

Two or more years experience as a medical assistant,

office assistant or other healthcare service administrative

support role.

This offer from "Saviance Technologies Pvt. Ltd." has been enriched by Jobgether.com and got a 72% flex score.

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