Job Description:
Location: Eagan, MN
Description: Medical Mgmt Specialist I - Eagan MN Market
Job Summery:
- Responsible for providing non-clinical support to the Medical Management and/or Operations areas.
Primary duties may include, but are not limited to:
- Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
- Provides information regarding network providers or general program information when requested. May assist with complex cases.
- May act as liaison between Medical Management and/or Operations and internal departments. Maintains and updates tracking databases.
- Prepares reports and documents all actions.
- Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.
- Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
- Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Required Skillset and Experience:
- Proficient in MS Office products, in particular Excel.
- Previous knowledge or experience with health insurance operations.
- Ability to multi-task and have multiple screens and windows open at one time.
- Comfortable with telework environment since not at physical location at time of posting.
- Good customer service skills with individuals across teams in the organization and outside parties.
- Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Education:
- Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
Anticipated work schedule:
8:00am-5:00pm CST
Contact: mmabry@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
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