Medical Management Assistant
Core
Supports the Medical Management department by responding to provider calls, entering inpatient/outpatient data into case management systems, and authorizing SCAN services under clinical direction.
Role type
Medical Management Assistant (Utilization Management)
Builds
Quality care and service delivery for SCAN members (older adults) via authorized services and data management.
Domain
Healthcare / Managed Care / Medicare Advantage
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Data entry, Medical terminology, Utilization Management, ICD-9/CPT coding, Medicare/Medi-Cal guidelines knowledge, Telephonic communication
Preferred skills
Associate's Degree, 3+ years managed care experience, MS Office proficiency
Technologies
CCMS, MS Office
Responsibilities
Respond to provider calls and faxes; Enter inpatient and related data into case management system; Authorize SCAN services under clinical direction; Verify member eligibility and benefits; Maintain data entry requirements per workflows; Ensure effective working relationships with providers.
Seniority
Individual Contributor, entry-to-mid level