Care Management Associate

3 weeks ago


Schenectady, United States US Tech Solutions Full time
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.
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