Medical Mgmt Specialist I at The Judge Group Inc. in Coronado, California

Job Description:

Location: Coronado, CA

Description: Medical Mgmt Specialist I



This job will have the following responsibilities:

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


• 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.

Qualifications & Requirements:

• Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
  
  

Contact: khawkins@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com Apply Now