Medical Management Specialist I

1 day ago


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

The Medical Management Specialist I is a key member of our team, providing non-clinical support to the Medical Management and/or Operations areas. This role requires a strong understanding of managed care and Medicaid/Medicare, as well as excellent communication and organizational skills.

Key Responsibilities
  • Gather clinical information regarding cases and determine the appropriate area to refer or assign the case.
  • Provide information regarding network providers or general program information when requested.
  • Assist with complex cases and act as a liaison between Medical Management and/or Operations and internal departments.
  • Maintain and update tracking databases, preparing reports and documenting all actions.
Requirements
  • Requires a H.S. diploma or equivalent and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background.
Preferred Skills
  • Understanding of managed care or Medicaid/Medicare strongly preferred.

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.



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