Medical Management Specialist I - Kansas at Elevance Health in Topeka, Kansas
Posted in Other 3 days ago.
Job Description:
The Medical Management Specialist I is responsible for providing non-clinical support to the Medical Management and/or Operations areas.
Location: The ideal candidate will live within 50 miles of our Topeka, Kansas OR Olathe/Overland Park, Kansas Elevance Health location.
How you will make an impact:
- 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.
Minimum 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 Skills, Capabilities, and Experiences:
- Understanding of managed care or Medicaid/Medicare strongly preferred.
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