Job Title
Phone, Computer, Organized, Detail-oriented, and effective at multitasking support for Case management team.
Expected Schedule: 8:30am-5pm EST
Location: Florida
Top Skills Required: Phone, Computer, Organized, Detail-oriented, and effective at multitasking.
Duties and Responsibilities:
- 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.
Knowledge, Skills and Abilities:
- 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 Years of Experience: 1-3 years' experience in an administrative support role in healthcare.