Medical Management Specialist II

3 days ago


Topeka, Kansas, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Medical Management Specialist II to join our team at Elevance Health. This is a hybrid role that will work in a remote and office setting, with the ideal candidate living within 50 miles of our Topeka, Kansas location.

Key Responsibilities
  • Provide non-clinical support to medical management operations, including handling complex file reviews and inquiries from members and providers.
  • Gather clinical information regarding cases and determine the appropriate area to refer or assign the case.
  • Conduct initial reviews of files to determine the appropriate action required and maintain and update tracking databases.
  • Prepare reports and documents all actions, and respond to requests, calls, or correspondence within scope.
  • Provide general program information to members and providers as requested, and may review and assist with cases.
  • Act as a liaison between medical management operations and other internal departments to support the administration of medical benefits.
  • May assist with case referral processes and collaborate with external community-based organizations to facilitate and coordinate care under the direction of an RN Case Manager.
Requirements
  • High school diploma and a minimum of 3 years of administrative and customer service experience, or any combination of education and experience that would provide an equivalent background.
  • Knowledge of managed care or Medicaid/Medicare concepts is strongly preferred.
  • Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Work Environment

This is a hybrid role that will work in a remote and office setting, with the ideal candidate living within 50 miles of our Topeka, Kansas location. Elevance Health operates in a Hybrid Workforce Strategy, and associates are required to work at an Elevance Health location at least once per week.



  • Topeka, Kansas, United States Elevance Health Full time

    Job SummaryWe are seeking a highly skilled Medical Management Specialist II to join our team at Elevance Health. As a key member of our medical management operations, you will provide non-clinical support to our medical management teams, handling complex file reviews and inquiries from members and providers.Key ResponsibilitiesCase Review and Management:...


  • Topeka, Kansas, United States Capitol Federal Savings Bank Full time

    Position Overview: The Records Management Specialist II plays a crucial role in ensuring the integrity and accessibility of company records. This position involves a thorough review of customer deposits and encompasses a variety of responsibilities related to the maintenance and research of records. Key Responsibilities: Conduct comprehensive searches of...


  • Topeka, Kansas, United States Capitol Federal Savings Bank Full time

    Position Overview: The Records Management Specialist II plays a crucial role in ensuring the integrity and accessibility of company records. This position involves reviewing customer deposits and performing various tasks essential for maintaining and investigating the organization's documentation to comply with industry standards, customer expectations, as...


  • Topeka, Kansas, United States Capitol Federal Savings Bank Full time

    Position Overview: The Records Management Specialist II plays a crucial role in ensuring the integrity and accessibility of company records. This position involves a thorough review of customer deposits and encompasses a range of responsibilities aimed at maintaining and investigating the organization’s records to comply with industry standards, customer...


  • Topeka, Kansas, United States Walmart Full time

    Job SummaryThis is a challenging and rewarding role that requires a high level of expertise in project management, operations management, and business analysis. As a Project Manager II, Implementation And Sustainment Specialist, you will be responsible for leading large projects or multiple medium-sized projects, developing and implementing resource plans,...


  • Topeka, Kansas, United States Titan Medical Full time

    Position Overview:Titan Medical Group is actively seeking a travel Medical Laboratory Specialist for an exciting opportunity.Job Details:Specialty: Medical Laboratory SpecialistField: Allied Health ProfessionalContract Duration: 13 weeksWeekly Hours: 40 hoursShift Schedule: 8-hour shifts, daytimeEmployment Type: TravelQualifications: Candidates must possess...


  • Topeka, Kansas, United States Umanist Staffing LLC Full time

    Job DescriptionUmanist Staffing LLC is seeking a skilled Healthcare Consultant II - Telehealth Specialist to join our team. As a key member of our organization, you will play a critical role in developing and implementing effective health services strategies, policies, and programs that drive quality healthcare delivery and establish a competitive business...


  • Topeka, Kansas, United States Conflux Systems Full time

    Job OverviewPosition Title: Healthcare Consultant IICompany: Conflux SystemsRole Summary: The Healthcare Consultant II will provide essential healthcare management services aimed at optimizing treatment pathways, controlling healthcare expenditures, and enhancing operational efficiency within healthcare programs.Key Responsibilities:Conduct thorough...


  • Topeka, Kansas, United States Impresiv Health Full time

    Job Description:Job Title: Healthcare Consultant IIJob Summary:We are seeking a highly skilled Healthcare Consultant II to join our team at Impresiv Health. As a Healthcare Consultant II, you will play a critical role in providing comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs,...


  • Topeka, Kansas, United States BCforward Full time

    Oracle Identity and Access Management SpecialistCompany: BCforwardLocation: RemoteContract Duration: 6 Months with Potential for ExtensionJob Type: Full-Time ContractCompensation: $60 - $65/hrJob Overview:We are seeking a dedicated Oracle Identity and Access Management Specialist to provide essential runtime service support for the Oracle Identity and Access...


  • Topeka, Kansas, United States DispatchHealth Management Full time

    About the RoleWe are seeking a highly skilled and compassionate Medical Technician to join our team at DispatchHealth Management. As a Medical Technician, you will play a critical role in delivering high-quality, patient-centered care in the comfort of patients' homes.Key ResponsibilitiesWork under the supervision of licensed Nurse Practitioners/Physician...


  • Topeka, Kansas, United States Walmart Full time

    **Job Summary**We are seeking a highly skilled Project Manager II to join our team at Walmart. As a key member of our organization, you will be responsible for leading projects that drive business growth and improvement.**Key Responsibilities**Develop and implement tools and processes to support project initiatives and drive business results.Lead and define...


  • Topeka, Kansas, United States BEST Crowd Management Full time

    Job Title: Event Security SpecialistCompany: BEST Crowd ManagementLocation: Various VenuesPay: $15 / hrJob Type: Part-timeSummary:We are seeking a highly skilled and adaptable Event Security Specialist to join our dynamic team at BEST Crowd Management. As an Event Security Specialist, you will be responsible for ensuring the safety and security of event...


  • Topeka, Kansas, United States Impresiv Health Full time

    About the RoleWe are seeking a highly skilled Healthcare Consultant II to join our team at Impresiv Health. As a key member of our clinical operations team, you will play a critical role in providing comprehensive healthcare management services to our clients.Key ResponsibilitiesEvaluation and Case Management: Conduct thorough evaluations of referred...


  • Topeka, Kansas, United States Kansas Action for Children Full time

    Job Overview:Position: Medication Order Processing SpecialistLocation: KansasKey Responsibilities:1. Assess, interpret, and enter medication orders into the electronic medication management system while adhering to accuracy and efficiency benchmarks.2. Conduct pharmaceutical calculations and address issues related to claim denials identified during...


  • Topeka, Kansas, United States Elevance Health Full time

    Healthcare Operations Coordinator IILocation: Kansas. This role operates in a hybrid model, combining remote work with office responsibilities. Candidates should ideally reside within a 50-mile radius of the Topeka, Kansas Elevance Health PulsePoint location.The Healthcare Operations Coordinator II plays a crucial role in delivering non-clinical assistance...


  • Topeka, Kansas, United States Elevance Health Full time

    Job SummaryWe are seeking a highly skilled Medical Management Specialist II to join our team at Elevance Health. This role will provide non-clinical support to medical management operations, handling complex file reviews and inquiries from members and providers.Key ResponsibilitiesGather clinical information regarding cases and determine the appropriate area...


  • Topeka, Kansas, United States CIMCO MANAGEMENT COMPANY Full time

    Job OverviewWe are seeking a skilled Property Maintenance Specialist to manage a variety of tasks related to the upkeep of rental properties.Key Responsibilities:Perform painting and finishing work to enhance property aesthetics.Conduct appliance repairs to ensure functionality and tenant satisfaction.Execute plumbing repairs to maintain property...


  • Topeka, Kansas, United States Elevance Health Full time

    Position Title:Healthcare Operations Coordinator IIJob Overview:The Healthcare Operations Coordinator II plays a pivotal role in supporting non-clinical functions within medical management operations. This position is designed for individuals who can manage complex inquiries and file assessments from both members and healthcare providers.Key...


  • Topeka, Kansas, United States ProfDoc Full time

    Clinical Medication Specialist in StaffordJoin ProfDoc, a forward-thinking organization focused on improving patient care through innovative healthcare solutions. We are dedicated to creating new services and enhancing healthcare delivery by collaborating with local community resources, mental health services, social care, and voluntary organizations to...