Healthcare - Case Management Processor

Dice is the leading career destination for tech experts at every stage of their careers. Our client, OMG Technologies, is seeking the following. Apply via Dice today!

Healthcare - Case Management Processor, Remote.

We are looking to hire a candidate with the below skill sets mentioned and experience for one of our major clients within the Health Insurance industry. This is a REMOTE role, for 3 -month contract opportunity. Interested candidates may share their updated resumes with Sudhasini – OMG Technologies.

This position is fully remote; time zone requirements should be available until 6pm PST. The schedule will be Monday – Friday 8-5pm PST.

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)

• Promotes communication, both internally and externally to enhance effectiveness of case management services (e.g., health care providers and health care team members).
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Reviews data to identify principle member needs and works under the direction of the Case Manager to implement care plan.
• Provides support to the Case Management staff performing non clinical activities and supporting the management of the department.
• Protects the confidentiality of member information and adheres to company
• Runs reports to assist in coordination of case management needs.
• Responsible for initial review and triage of Case Management tasks.
• Screens members using Molina policies and processes assisting clinical Case Management staff as they identify appropriate medical services
• Coordinates required services in accordance with member benefit plan.
• Provides support services to case management team members by answering telephone calls, taking messages and researching information.

Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job satisfactorily)

• Ability to work in a fast paced environment
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Working knowledge of medical terminology and abbreviations
• PC experience in Windows environment and accurate data entry at 40 WPM minimum.
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
• Good interpersonal/team skills
• Must have a high regard for confidential information
• Demonstrated ability to communicate, problem solve, and work effectively with people
• Able to work independently and as part of a team.
• Ability to think analytically and to problem solve.
• Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity to concerns, proactive identification and resolution of issues to promote positive outcomes for members

Must have requirement: Medical terminology knowledge, customer service and telephonic experience.

Day to day responsibilities: Contacting pregnancy members telephonically to complete a health assessment

Required Education:

High School Diploma or G.E.D.

Other job specifications:

• Employment Type: Contract to Hire (CTH), W2 only. NO C2C.
• Job Types: Full-time, Contract
• Contracting Period: 3 -month contracting opportunity.

Job Location: The position is fully remote.

Contract Rate/Salary: $24/hr. on W2.

Interested candidates may apply through Dice or share their updated resumes with Sudhasini – OMG Technologies.