Medical Mgmt Specialist I at The Judge Group Inc. in Eagan, Minnesota

Job Description:

Location: Eagan, MN

Description: Medical Mgmt Specialist I - Eagan MN Market

Job Summery:

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

Primary duties may include, but are 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.


• 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.


• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Required Skillset and Experience:

• Proficient in MS Office products, in particular Excel.


• Previous knowledge or experience with health insurance operations.


• Ability to multi-task and have multiple screens and windows open at one time.


• Comfortable with telework environment since not at physical location at time of posting.


• Good customer service skills with individuals across teams in the organization and outside parties.


• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Education:

• 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.

Anticipated work schedule:

8:00am-5:00pm CST



Contact: mmabry@judge.com


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