Care Management Associate

Job Title

Job Description:

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.

Experience:

1+ years of experience in a healthcare setting.

Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.

Medical Terminology

Skills:

Strong communication, interpersonal, and prioritization skills

Must be highly organized and detail-oriented.

Ability to work in a fast paced, rapidly changing environment

Customer service skills with the ability to work in a team environment.

Education:

Verifiable High School diploma or GED is required.

About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.