Care Management Associate LeadPrimary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix Apply
64519Fundamental Components: The main function of this role will be to complete reports that are turned into our regulators at Medicare and Medicaid. The reports need to be done accurately, with a major focus on detail, and finding mistakes before submission. This role will also be to help the team write or audit notice of action letters. These letters creatively translate physical health, behavioral health, and medication information into member readable language using business knowledge and available resource tools. The letters must translate complicated and technical medical terminology into clear, concise communication for various target audiences. The letters follow Medicare and Medicaid guidance around language and templates.
In addition to reports and notice of action letters, you may have to take phone calls and faxes from providers (clinics, hospitals, doctors) requesting prior authorization approval, make calls to providers or members, data entry any faxes that are received from providers, and complete special projects in accordance to business needs (i.e. return mail, member surveys, sorting).
The above job duties require timely submissions and meeting time frames according to the Medicare and Medicaid market. The team lead must be able to access documentation libraries to ensure communication is consistent, communicate any errors and potential problems with leadership, and assign authorizations as needed to help facilitate timeliness. Our focus is on compliance and doing the right things for the right reasons. This is a high production team, so you will need to be efficient, productive and thorough in all work that is done. You will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our providers and our members. This is a great opportunity to bring your skills and talents to a role where you’ll have a chance to make an impact. Background Experience:
- Computer literacy in order to navigate through internal/external computer systems, including Windows 10, Outlook, Excel and Word.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants.
- Familiarity with basic medical terminology and concepts used in care management.
- Effective written and spoken communication, telephonic and organization skills.
- Understanding of health care business, and business or technical writing preferred.
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to health issues, proactive identification and resolution of issues to promote positive outcomes for members.
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