Medicaid Care Manager - Care Coordination & Travel

Molina Healthcare Inc; Midvale (UT); Sur place; USD 60 000 - 78 000; Plein temps

Résumé du poste

Molina Healthcare Inc. in Utah is hiring a Care Coordination Specialist to review Medicaid claims and identify members meeting Restriction Program criteria, including overutilization of emergency services, multiple prescribers, and multiple pharmacies.

You will manage a 12-month intervention caseload, provide care coordination and monitoring, collaborate with providers to implement lock-in assignments to a designated provider and pharmacy, and travel locally 25-40% as required.

Qualifications

• At least 2 years of health care experience, preferably care management or related setting.
• Licensure/certification required only if mandated by state contract or licensing mandates.
• Valid and unrestricted driver's license and reliable transportation for local travel.
• Ability to work with diverse populations and across settings.
• Proactive, detail-oriented, and able to manage multiple projects.

Responsabilités

• Review Utah Medicaid claims data to identify members meeting Restriction Program criteria.
• Manage a 12-month intervention caseload with care coordination and monitoring.
• Collaborate with providers to implement lock-in assignments to a designated provider and pharmacy.
• Perform assessments and develop care plans with the care team.
• Conduct telephonic or in-person visits and track progress.

Connaissances

Communication skills

Time management

Problem solving

Detail oriented

MS Office proficiency

Formation

Bachelor\'s degree in health care related field

Clinical licensure/certification (as required by state contract)

Outils

MS Office

Description du poste

Molina Healthcare Inc. in Utah is hiring a Care Coordination Specialist to review Medicaid claims and identify members meeting Restriction Program criteria, including overutilization of emergency services, multiple prescribers, and multiple pharmacies.

You will manage a 12-month intervention caseload, provide care coordination and monitoring, collaborate with providers to implement lock-in assignments to a designated provider and pharmacy, and travel locally 25-40% as required.