Care Management Associate
Core
Coordinate medical services, triage care team tasks, and implement care plans to promote effective healthcare utilization and quality.
Role type
Care Management Associate (Healthcare Operations)
Builds
Care plans and coordinated healthcare service delivery
Domain
Healthcare / Health Insurance
Required skills
Healthcare field experience, medical billing and coding, call center/customer service, independent work, multi-system navigation, Microsoft Office 365, clinical platforms, health plan systems
Preferred skills
Medical terminology knowledge, compliance with PM policies and regulatory standards, accurate documentation, claims payment issue resolution, hospital care administration
Technologies
Microsoft Office 365, clinical platforms, health plan systems, EHR portal, VPN
Responsibilities
Review and triage Care Team tasks, screen patients using intervention business rules, make referrals to medical services staff, coordinate required services per benefit plan, monitor non-targeted cases for discharge dates, identify outlier cases for clinical staff, utilize systems to build and enter member information, support development and implementation of care plans, promote communication with providers and team members, perform non-medical research for case management.
Seniority
Mid-level, hands-on IC