Case Management Processor
Job Details
JOB DESCRIPTION
Job Summary
Company Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Provides telephone, clerical, and data entry support for the Case Management team.
- Responsible for initial review of assigned case levels to assist in Case Management assignment.
- Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
- Schedules member visits with team members as needed.
- Screens members using Company 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.
- Processes member and provider correspondence.
JOB QUALIFICATIONS
Required Education
HS Diploma or GED
Required Experience
1-3 years’ experience in an administrative support role in healthcare.
Preferred Education
Associate degree
Preferred Experience
3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.
#PJHS2
#LI-AC1
To all current Company employees: If you are interested in applying for this position, please apply through the intranet job listing.
Company offers a competitive benefits and compensation package. Company is an Equal Opportunity Employer (EOE) M/F/D/V.
Sign up and search through 3,103 curated jobs in the Healthcare Edition:
SIGN UP & APPLY
More Interviews
Guaranteed in 30 Days
We guarantee that you will
get more job interviews
in 30 days after using our resume writing services or we will rewrite
your resume for free.