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Case Management Associate Analyst

2 months ago

Bloomington, United States Tailored Management Full time
Title: Case Management Associate Analyst
Location: 100% Remote - Candidate can be located in any time zone as long as they can commit to the CST hours for the role.
Schedule: Monday to Friday - 10:30-7 CST
Initial Assignment Length: 3 Months Contract - possibility of an extension/conversion based on the attendance, performance, and business need)

A global health insurance provider whose mission is to improve the health, well-being, and peace of mind of those the company serves. Become a part of this ever-growing, deeply caring, and collaborative healthcare industry leader today

Description:
  • Complete scheduling of peer reviews for all lines of business, 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

Skills:
  • 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

Education:
  • Bachelor's degree in mental health field or psychology/social work related field required (can also include: family communications, health coaching, community/public health or other related major).
  • This is a non-clinical role and does not require a license
  • Previous customer service experience or related position

Languages:
• English - Read Write Speak

Should you accept an offer for a contract opportunity with our client, the following pre-employment items will be required: 7-year criminal background check, which will include verifying your highest level of education completed and your employment history for the last 7 years, and a urine drug test analysis (does not look for marijuana/THC). You may be required to provide documentation (copy of your diploma or licenses, W2's or Pay stubs) to help us verify this information.