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Job Requirements of Care Management Associate:
-
Employment Type:
Contractor
-
Location:
Phoenix, AZ (Onsite)
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Care Management Associate
Careers Integrated Resources Inc
Phoenix, AZ (Onsite)
Contractor
Job Title: Care Management Associate
Location: Phoenix, Client
Job Duration: 6+ Months
Shift: Mon- Fri 8:00 am to 5:00 Pm
Position Summary:
Role/Responsibilities:
Education:
Location: Phoenix, Client
Job Duration: 6+ Months
Shift: Mon- Fri 8:00 am to 5:00 Pm
Position Summary:
- The Coordinator III will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis.
- Provide call center outreach to members related to referrals, gaps in care and services needed. Assist with appointment scheduling, transportation scheduling and referral assistance.
Role/Responsibilities:
- Utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources.
- Will assist with auth creation, appointment scheduling, and outreach to members, referral follow up.
- Support comprehensive coordination of medical services including member transitions, screening and supporting the implementation of referrals to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.
- Create authorizations in QNXT to support continuity of care for member.
- Screens incoming forms using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
- Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services
- Call Center Experience
- Preferred Strong Customer Service Skills
- Strong Problem-Solving And Analytical Skills
- Possess Strong Computer Navigation Skills
- Comfortable With Regular Feedback And Development
- Works Well In A Team Environment
- Must Have Basic Medical Terminology Experience
Education:
- High school diploma or GED required, 1-2+ years of call center experience.
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