Description: Medical Mgmt Specialist I - Eagan MN Market
Job Summery:
Responsible for providing non-clinical support to the Medical Management and/or Operations areas.
Primary duties may include, but are not limited to:
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.
Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Required Skillset and Experience:
Proficient in MS Office products, in particular Excel.
Previous knowledge or experience with health insurance operations.
Ability to multi-task and have multiple screens and windows open at one time.
Comfortable with telework environment since not at physical location at time of posting.
Good customer service skills with individuals across teams in the organization and outside parties.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Education:
Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
Anticipated work schedule:
8:00am-5:00pm CST
Contact: mmabry@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
