Medical Management Specialist I
Core
Provides non-clinical support to Medical Management and Operations by gathering clinical information, determining case referrals, and maintaining tracking databases.
Role type
Entry-level Medical Management Specialist (Non-Licensed)
Builds
Operational support for medical management workflows and case tracking
Domain
Healthcare / Managed Care
Deliverable
dashboards & analysis
Required skills
Case information gathering, Database maintenance, Report preparation, Liaison communication
Preferred skills
Managed care knowledge, Medicaid/Medicare understanding, Prior-authorization experience, Case management experience, Bilingual (English/Spanish)
Technologies
Tracking databases
Responsibilities
Gather clinical information to determine case referral areas, Provide network provider information, Assist with complex cases, Act as liaison between departments, Maintain and update tracking databases, Prepare reports and document actions
Seniority
Entry-level, Non-Management