Medical Management Specialist I

Position Title: Medical Management Specialist I Anticipated End Date: 2026-07-17 This role enables associates to work virtually full‑time, except for required in‑person training sessions, providing maximum flexibility and autonomy. The approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. Schedule: Monday through Friday, 8AM‑5PM EST/PST. How you will make an impact Gather clinical information regarding case and determine appropriate area to refer or assign case (utilization management, case management, QI, Med Review). Provide information regarding network providers or general program information when requested. Assist with complex cases. Act as liaison between Medical Management and/or Operations and internal departments. Maintain and update tracking databases. Prepare reports and document all actions. Responsibilities exclude conducting any utilization management review activities that require interpretation of clinical information. Minimum Requirements High school diploma or equivalent. Minimum 1 year of experience or an equivalent combination of education and experience. Preferred Skills, Capabilities and Experiences Understanding of managed care or Medicaid/Medicare strongly preferred. For URAC accredited areas, expected: strong oral, written and interpersonal communication skills; problem‑solving skills; facilitation skills; analytical skills. Compensation and Benefits Salary range: $20.70 to $29.75 per hour (subject to location, experience and market factors). Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution (subject to eligibility), medical, dental, vision, short‑term and long‑term disability, life insurance, wellness programs and financial education resources. Equal Employment Opportunity Statement Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. #J-18808-Ljbffr