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. Apply tot his job Apply To this Job