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Healthcare Management Support Specialist

2 months ago

Dallas, Texas, United States Imagine360 Full time

Imagine360 is seeking a Medical Management Support Specialist to enhance our operational efficiency. This role involves providing essential support to Medical Management Clinicians by handling various non-clinical tasks and projects as assigned.


Position: 100% Remote


Key Responsibilities:

  • Assist the Medical Management Supervisor and Clinicians with non-clinical duties as directed.
  • Assign cases to clinical staff based on established criteria and facilitate the transfer of both clinical and non-clinical data.
  • Engage professionally with external providers and vendors to aid in case documentation and request necessary clinical documents.
  • Conduct non-clinical outreach calls to clients to collect information pertinent to program enrollment.
  • Facilitate Stop Loss communications by dispatching letters to relevant carriers as instructed.
  • Monitor departmental email communications and allocate cases to clinical personnel as needed.
  • Compile and distribute program satisfaction survey results to relevant stakeholders.
  • Generate and organize internal and external reports as required.
  • Maintain an inventory of educational resources for the team.
  • Distribute educational materials and letters related to Medical Management programs to members.
  • Process returned mail associated with Medical Management.
  • Prepare and manage new hire documentation as necessary.
  • Assist in organizing and participating in scheduled meetings and training sessions.
  • Conduct participant assessments as assigned.
  • Collaborate effectively within a team to achieve positive outcomes for members and clients.
  • Adhere to Medical Management policies, procedures, and HIPAA/PHI guidelines while escalating issues appropriately.
  • Ensure timely and accurate completion of all assigned tasks.
  • Engage in quality improvement programs as assigned.
  • Complete HIPAA training annually and comply with all relevant guidelines.
  • Perform additional duties as assigned.

Required Qualifications:

  • 0-1+ years of experience in an administrative support capacity.
  • Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.
  • Familiarity with internet navigation and database software.

Preferred Qualifications:

  • Experience in an administrative support role within non-clinical healthcare operations is preferred.

What Imagine360 Offers:

  • Multiple health plan options with 100% employee-paid premiums.
  • Fully covered employee premiums for dental, vision, short-term disability, long-term disability, and life insurance.
  • Parental leave policy.
  • 20 days of paid time off to start, plus 10 paid holidays.
  • Tuition reimbursement opportunities.
  • 401k company contributions.
  • Professional development and continuous learning initiatives.
  • Opportunities to engage in the company's diversity and inclusion efforts.

Imagine360 is a health plan solution provider with over 50 years of expertise in self-funding healthcare. We have successfully assisted numerous employers in reducing healthcare costs significantly. Our innovative health plan solutions address the shortcomings of traditional PPO insurance by offering tailored, member-focused options.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.


Note for Recruitment Agencies: Imagine360 will only accept applications from agencies or business partners that have been invited to work on a specific role. Unsolicited candidate resumes submitted without permission will not be considered, and no fee will be payable. Thank you for your understanding.