Care Management Associate
Job Details
Bring your heart to Company. Every one of us at Company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at Company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Support Comprehensive coordination of National Medical Excellence Program.
– Utilizes ASD/ATV/HRP/MedCompass and other Aetna systems to build, research and enter member information in applicable system.
– Performs non-medical research including eligibility verification, COB, and benefits verification.
– Maintains accurate and complete documentation of required information and meets risk management, regulatory and accreditation requirements.
_ Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
– These duties may include but are not limited to processing referrals, making outreach calls, entering data.
-Collaborates with the clinical team, medical directors, claims and contacting staff.
-Communicates with transplant financial coordinator at the transplant center.
-Initiates authorizations regarding kidney transplants.
-Communicates with the member regarding transplant services.
-Other duties as assigned.
Required Qualifications
-Computer skills, including in MS Office
-Ability to communicate with diverse populations
-Ability to collaborate with and work in a team environment
-Flexibility and ability to work independently
Preferred Qualifications
-Prior insurance experience
-Call center experience
-Customer Service experience over the phone
Education
Associates degree, or equivalent experience
Pay Range
The typical pay range for this role is:
$18.50 – $35.29
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a Company bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. Company also offers numerous well-being programs, education assistance, free development courses, a Company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Company website
We anticipate the application window for this opening will close on: 05/03/2024
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