Medical Management Coordinator

Location: Louisville, KY
Date Posted: 05-10-2018
CareNational
Medical Management Coordinator - Managed Care
Indianapolis, IN
 
*** This is a full-time, benefits available, CONTRACT position, expected to last 6 months, or longer! ***
 
Medical Management Coordinator Job Summary:
  • Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
  • Provides information regarding network providers or general program information when requested.
  • May assist with complex cases.
  • May act as liaison between Medical Management and/or Operations and internal departments. Maintains and updates tracking databases.
  • Prepares reports and documents all actions.
  • Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.
Medical Management Coordinator Background: 
 
  • Requires an education level of at least a high school diploma or GED; Associate’s or Bachelor’s degree is a plus.
  • Requires exceptional phone / customer service skills, as well as very strong computer user skills.
  • At least 1 years’ experience in a medical office, hospital or health plan call center, or other healthcare support role with heavy computer & phone use.
  • Strongly prefer 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc).
  • Requires basic to intermediary familiarity with Medical terminology (1-3 years direct experience).
  • Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product.
  • Knowledge of health care delivery system, Medicaid/Medicare and related state programs is required.
  • Advanced computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
  • Ability to work regularly scheduled shifts within hours of operation (flexible scheduling for later start times is available!)
 
#Admin
David DiVito
Division Director
CareNational Healthcare Services
david@carenational.com
480.425.2451 (CALL – TEXT – FAX)
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