Medical Management Specialist II

4 weeks ago


Atlanta, Georgia, United States Elevance Health Full time
Job Summary

The Medical Management Specialist II is responsible for providing non-clinical support to medical management operations. This includes handling complex file reviews and inquiries from members and providers.

Key Responsibilities

Gather clinical information regarding cases and determine the appropriate area to refer or assign the case.

Conduct initial reviews of files to determine the required action.

Maintain and update tracking databases.

Prepare reports and document all actions.

Respond to requests, calls, or correspondence within scope.

Provide general program information to members and providers as requested.

Requirements

High school diploma or equivalent and a minimum of 3 years of administrative and customer service experience.

Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

What We Offer

We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We also provide medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.

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