Medical Management Specialist

2 weeks ago


New Hyde Park, New York, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Medical Management Specialist to join our team at Elevance Health. As a key member of our Medical Management team, you will play a critical role in providing non-clinical support to our Medical Management and Operations areas.

Key Responsibilities
  • Gather and analyze clinical information to determine the most appropriate course of action for each case.
  • Provide information and support to network providers and internal departments as needed.
  • Assist with complex cases and act as a liaison between Medical Management and Operations teams.
  • Maintain and update tracking databases to ensure accurate and timely reporting.
  • Prepare and document all actions and reports to ensure compliance and quality standards.
Requirements
  • High School diploma or equivalent required; 1 year of experience or equivalent combination of education and experience preferred.
  • Proficiency in English and/or additional languages (Chinese, Russian, Spanish, Bengali, or Korean) preferred.
  • Service delivery coordination experience in a managed care setting preferred.
  • Experience working with the Medicaid population and LTSS or managed care organization experience highly preferred.
What We Offer

At Elevance Health, we offer a comprehensive benefits package, including medical, dental, vision, and 401(k) + match. We also offer incentive and recognition programs, equity stock purchase, and financial education resources.

We operate in a Hybrid Workforce Strategy, with associates required to work at an Elevance Health location at least once per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19.



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