Medical Management Specialist

1 week ago

Henderson, United States P3 Health Partners Full time

People. Passion. Purpose.

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.

We are looking for a Medical Management Specialist. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.

Medical Management Specialist

Overall Purpose:

Under the supervision of the Medical Management Nurses, this position is responsible for assisting the Medical Management department with clerical work, inbound and outbound phone calls and faxes, mailings, processes that do not require RN intervention, based on the scope of practice within the state. Through collaborative teamwork the clerk will assist the department and P3 Health Partners to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.

Education and Experience:

* High School graduate required * Education as a medical assistant or nursing school student helpful

Essential Functions:

* Promote the mission, vision and values of P3 Health Partners * Answers the Prior Authorization phone line and acts as the first line of contact to inbound callers * Provides administrative functions to support UM Prior Authorization and Concurrent Review Team * Sends follow up fax and mail communication or follow up telephone calls to providers and patients notifying them of approved outpatient authorizations * Responsible for managing fax server indexing buckets and updating provider information * Assists Medical Management team in gathering additional clinical information when applicable * Supports the Medical Management team with appropriate referrals, claims history or any other clinical information necessary * Responsible for timely and accurate documentation in systems * Strong problem-solving skills required * Experience in a managed care organization preferred * Knowledge of medical terminology required * Excellent communication skills with patients, providers, internal and external customers required * Must have excellent computer skills * Must have excellent organizational skills, attention to detail, and ability to work independently

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