Healthcare - Case Management Processor

Will this role be fully remote?: Yes
Are there any specific locations the candidates should be in (i.e., do they need to live in IL): Texas
What is the expected schedule (include dates/time/timezone): M-F 8am-5pm CST (1 hour lunch)
Minimum requirements: HS Diploma or GED & 1-3 years' experience in an administrative role in healthcare
What additional IT equipment is required outside of a laptop/headset/mouse/keyboard (i.e., dual monitor & docking station or single monitor & connecting cables – note these will be billed back to Molina at cost): dual monitors and docking station.
Is there potential for this to extend past 6 months and/or convert to an FTE? Set to end 09/15/2027 – there is not an expectation to convert to a FTE

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.