Offer summary

Qualifications:

High School Diploma or G.E.D. required., Two or more years of experience in a healthcare administrative support role., Excellent communication and customer relation skills are essential., Proficiency in technology and documentation is necessary..

Key responsibilities:

Conduct outbound calls to Medicaid members to assess their health needs.

Assist Case Management staff with non-clinical activities and manage departmental tasks.

Coordinate services according to member benefit plans and maintain accurate documentation.

Promote effective communication with healthcare providers and team members.

Job description

Hours 8-5 PST, Monday - Friday

• Will the position be 100% remote? Yes
• Are there any specific location requirements? Must reside in WA
• Are there are time zone requirements? Member outreach will be in Pacific time, 8 a.m – 5 p.m.
• What are the must have requirements? Excellent communication/customer relation skills; attention to detail; proficiency in documentation; proficient in technology/computer skills
• What are the day to day responsibilities? Outbound calls to Medicaid members to identify medical/BH/Social Determinants of health needs followed by referral/assignment to appropriate team
• Is there specific licensure is required in order to qualify for the role? No
• What is the desired work hours (i.e. 8am – 5pm) 8-5, Monday through Friday

Will require dual monitors and a docking station.

Potential to go perm: I think there is a possibility we may need this position on a permanent basis; however, we need to get caught up first and then see where we are at, through the end of the 6 mos we have the temp staff. If it looks like will need the resource ongoing, I will request a permanent full time position. There just isn't a way to determine that until we get through our backlog.

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)
· Provides support to the Case Management staff performing non clinical activities and supporting the management
of the department.
· Responsible for initial review and triage of Case Management tasks.
· Reviews data to identify principle member needs and works under the direction of the Case Manager to implement
care plan.
· Screens members using Molina policies and processes assisting clinical Case Management staff as they identify
appropriate medical services
· Coordinates required services in accordance with member benefit plan.
· Promotes communication, both internally and externally to enhance effectiveness of case management services
(e.g., health care providers and health care team members).
· Runs reports to assist in coordination of case management needs.
· Provides support services to case management team members by answering telephone calls, taking messages
and researching information.
· Maintains accurate and complete documentation of required information that meets risk management, regulatory,
and accreditation requirements.
· Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job
satisfactorily)
· Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity
to concerns, proactive identification and resolution of issues to promote positive outcomes for members
· Demonstrated ability to communicate, problem solve, and work effectively with people
· Working knowledge of medical terminology and abbreviations
· Ability to think analytically and to problem solve.
· Good interpersonal/team skills
· Must have a high regard for confidential information
· Ability to work in a fast paced environment
· Able to work independently and as part of a team.
· PC experience in Windows environment and accurate data entry at 40 WPM minimum.
· Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
· Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,
providers and customers

Required Education:
High School Diploma or G.E.D.

Required Experience:
Two or more years experience as a medical assistant,
office assistant or other healthcare service administrative
support role.

Required profile