Case Management Processor

Job Description

Job Summary

Must reside in Florida.

Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties

• Facilitates administrative support including case assignment, member screening and scheduling, correspondence processing, data entry and telephone and clerical support for team facilitating care management related services for members.
• Facilitates initial review of assigned case levels and assists in case management assignment to care managers.
• Reviews data to identify principle member needs and works under the direction of the care manager to implement care plan.
• Schedules member visits with care managers as needed.
• Screens members according to Molina policies and processes and assists care management staff during process of identifying appropriate member services.
• Coordinates required member services in accordance with member benefit plan.
• Promotes communication both internally and externally to enhance effectiveness of care management services.
• Processes member and provider correspondence.

Required Qualifications

• At least 1 year of experience in an administrative support role in health care, or equivalent combination of relevant education and experience.
• Strong attention to detail.
• Problem-solving skills.
• Working knowledge of Microsoft Office (Outlook, Word, Excel) or other comparable software.
• Excellent customer service skills.
• Time-management and organizational skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Certified Medical Assistant (CMA).