Care Management Processor - Remote (Must reside in MA)

Molina Healthcare

141d • $17 - $33 • Remote

About The Position

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Requirements

• HS Diploma or GED
• 1-3 years' experience in an administrative support role in healthcare.

Nice To Haves

• Associate degree
• 3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred.

Responsibilities

• Provides telephone, clerical, and data entry support for the Case Management team.
• Responsible for initial review of assigned case levels to assist in Case Management assignment.
• Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
• Schedules member visits with team members as needed.
• 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.
• Processes member and provider correspondence.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED