Case Management Processor

We have a great client that is looking for a Case Management Processor!

This is a contract role for 6 months with the potential to convert to direct hire.

Must live in the state of Washington.

Remote opportunity.

Monday through Friday, 8am to 5pm, PST.

Pay rate is $26.58

Will require dual monitors and a docking station.

Responsibilities:

Outbound calls to Medicaid members to identify medical/BH/Social Determinants of health needs followed by referral/assignment to appropriate team

Provides support to the Case Management staff performing non-clinical activities and supporting the management of the department.

Responsible for initial review and triage of Case Management tasks.

Reviews data to identify principle member needs and works under the direction of the Case Manager to implement a care plan.

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 (e.g., health care providers and health care team members).

Run reports to assist in coordination of case management needs.

Provides support services to case management team members by answering telephone calls, taking messages and researching information.

Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements

Requirements:

Working knowledge of medical terminology and abbreviations

PC experience in Windows environment and accurate data entry at 40 WPM minimum.

High School Diploma or G.E.D.

2+ years’ experience as a medical assistant, office assistant or other healthcare service administrative support role.