Case/Care Management Assistant

Position: Case/Care Management Assistant (remote)

Duration: 6-month contract (rolling extensions)

Location: Fully remote (Must work PST hours)

Hours: 9AM-5:30PM PST

Our client is looking for a Case/Care Management Assistant to process service requests, authorize referrals as appropriate, and ensure all case data is correctly entered in the various systems.

Day to Day:

• Supports department document control function by receiving and distributing cases from other sources, maintaining order in the Utilization Management document control room, and working cooperatively with other departments
• Assists in the data analysis in month end research of problem authorizations
• Assists in maintaining the integrity of the data systems by entering information into department’s data systems
• Provides administrative support to department management and staff, such as distributing mail, correspondence, ordering office supplies, scheduling meetings and faxing documents
• Contacts provider offices to gather data as needed for reports, problem resolution or to explain benefits
• Acts as liaison between the UM/CM when needed
• Assists in the entry of Care Manager notes when needed
• Receives, logs-in and distributes all case management referrals
• Provides coverage determination and/or eligibility status
• Other duties and projects as assigned
• Handles phone call- backs for the Care Managers, schedules beneficiary appointments
• Prepares regular and ad hoc reports and distributes as needed
• Authorizes services or referrals not requiring clinical review

Requirements:

• ~2 years of experience in medical environment
• Previous TRICARE, managed care, or case/care/utilization management experience preferred
• High School Diploma or College Degree

Soft Skills:

• Demonstrates a high level of accuracy, even under pressure
• Possesses intermediate flexibility to work in a fast-paced, dynamic environment.
• Friendly and service-oriented.