Care Management Processor

Molina Healthcare; Lexington (KY); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare provider is seeking a remote Case Management Processor to assist with outbound calls to MI Medicaid members, conduct health risk assessments, and provide exceptional customer service. The ideal candidate will have prior experience in healthcare administrative support, along with strong communication and multitasking skills. Join a dedicated team focused on quality care and support for our members, ensuring an effective and compassionate approach to healthcare management.

Benefits

Competitive benefits and compensation package

Qualifications

• 1-3 years’ experience in an administrative support role in healthcare required.
• 3+ years’ experience in an administrative support role in healthcare preferred.
• Community Health Worker certification highly preferred.

Responsibilities

• Provides telephone, clerical, and data entry support for the Case Management team.
• Schedules member visits with team members as needed.
• Processes member and provider correspondence.

Skills

Outbound call center experience

Excellence in customer service

Ability to toggle between screens/databases

Education

HS Diploma or GED

Associate degree

Job description

JOB DESCRIPTION

The Case Management Processor will be working 100% remote in an outbound call environment (Must reside in the state of KY). Our Case Management Processor will be working with our MI Medicaid members. This individual will be making outbound calls to our members to complete health risk assessments and answer any member questions. We are looking for candidates with outbound call center experience, excellence customer services, and ability to toggle back and forth between multiple screens and databases.

Community Health Worker certification highly preferred.

Home office with internet connectivity of high speed required.

Remote role, must be able to attend department meetings a few times of year

Monday – Friday 8:00 AM to 5:00 PM EST (No weekends or Holidays)

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

KNOWLEDGE/SKILLS/ABILITIES

• Provides telephone, clerical, and data entry support for the Case Management team.
• Responsible for initial review of assigned case levels to assist in Case Management assignment.
• Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
• Schedules member visits with team members as needed.
• 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.
• Processes member and provider correspondence.

JOB QUALIFICATIONS

Required Education

HS Diploma or GED

Required Experience

1-3 years’ experience in an administrative support role in healthcare.

Preferred Education

Associate degree

Preferred Experience

3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $14.16 - $29.06 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.