Medical Mgmt Specialist I

Elevance Health; Indianapolis (IN); Hybrid; USD 42,000 - 62,000; Full time

Benefits offered by this job

Major medical

HSA

Dental

Vision

Life insurance

Disability insurance

401k

Job summary

BCForward is seeking a non-clinical support specialist to assist Medical Management and Operations teams. The role involves gathering case information, liaising with departments, and maintaining tracking databases.

The candidate should have at least a high school diploma and one year of experience, or an equivalent combination of education and experience. The position is contract and Monday–Friday, 8am–5pm EST, remote but requires residence within 50 miles of PulsePoint.

Qualifications

• 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.

Responsibilities

• Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
• Provides information regarding network providers or general program information when requested.
• May assist with complex cases.
• May act as liaison between Medical Management and/or Operations and internal departments.
• Maintains and updates tracking databases.
• Prepares reports and documents all actions.

Education

High School diploma or equivalent

Job description

Job ID: JP00046953

Anticipated Start Date: 11/02/2026

Responsible for providing non-clinical support to the Medical Management and/or Operations areas.

Primary duties may include, but not limited to:

• Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
• Provides information regarding network providers or general program information when requested.
• May assist with complex cases.
• May act as liaison between Medical Management and/or Operations and internal departments.
• Maintains and updates tracking databases.
• Prepares reports and documents all actions.

Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.

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

Understanding of managed care or Medicaid/Medicare strongly preferred.

Job type

Contract

Monday - Friday 8am-5pm EST

Position is remote but the candidate would need to reside with 50 miles of any PulsePoint

About BCForward

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration. employed.

Benefits Information

BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

• major medical
• HSA
• dental
• vision
• employer-provided group life
• voluntary life insurance
• short-term disability
• long-term disability
• 401k

The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).