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Case Management Associate Analyst

3 months ago

Bloomington, United States Hire Talent Full time

This is a FULL TIME Work At Home Position.
Candidate can be located in any time zone as long as they can commit to the CST hours for the role. 10:30-7 CST.
Top 3 skills needed in candidates are empathy, strong technology skills and multi tasking.
Candidates MUST have reliable internet connection
Complete scheduling of peer reviews for all lines of business (CAMS, TruCare, and CareAllies) which includes building and verifying template information, making outbound/receiving inbound calls from facilities and providers to schedule reviews, coordinating MD/PHD calendars, documenting in the case, assigning for follow-up, and notifying Care Managers
Provide verbal determination to facilities and providers on results of peer reviews
Complete follow-up on cases after peer review including: creating alternative level of care authorizations, discharge planning, and appeal requests
Utilize workflows efficiently to ensure accurate documentation and adhere to compliance guidelines
Responsible for management of MD Scheduling mailbox
Work closely with internal matrix partners to ensure legal, federal, and state mandates are in compliance, and NCQA and URAC accreditation guidelines are met
Proficiently communicate with matrix partners including appeals coordinators, case managers, medical directors, individual HCP's, and facilities
Provide exceptional customer service, collaborating closely with matrix partners, to ensure each case is completed and effectively communicated to the customer and facility in a timely manner
Additional tasks as assigned

At least 2 years of experience in behavioral health services setting
Strong verbal, written, and interpersonal communication skills
Effective listening and analytical skills
Extremely detail oriented and proficient organizational skills
Strong ability to switch-task and exhibit excellent prioritization skills
Experience working on multiple projects simultaneously under tight deadlines
Technical knowledge of automated databases, tracking systems, spreadsheet applications
Ability to manage change effectively and assist in leading others through the change process