Care Management Associate

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

As a Care Management Associate, you will support comprehensive coordination of medical services, including Care Team intake, screening and implementation of care plans to promote effective utilisation of healthcare services.

Responsibilities:

• Initial review and triage of Care Team tasks
• Identify principal reason for admission, facility, and member product to correctly apply intervention assessment tools
• Screen patients using targeted intervention business rules and processes to identify needed medical services
• Make appropriate referrals to medical services staff and coordinate required services
• Monitor non-targeted cases for entry of appropriate discharge date and disposition
• Identify and refer outlier cases to clinical staff
• Utilise Med Compass and other Aetna systems to build, research and enter member information
• Support development and implementation of care plans
• Coordinate and arrange for healthcare service delivery under the direction of a nurse or medical director

Requirements:

• 2-4 years of experience in the healthcare field, medical/health setting, medical billing, and coding
• Experience in a call centre or customer service environment
• Ability to work independently and competently
• Strong written and oral communication skills
• Technical proficiency with Microsoft Office 365 applications and clinical platforms

Preferred Qualifications:

• Researching information and assisting in solving problems
• Adherence to Compliance with PM Policies and Regulatory Standards
• Maintained accurate and complete documentation of required information

Education:

• High School Diploma or G.E.D.

Work from Home Requirements:

• Direct/hardwired internet connection to a modem/router
• Quiet, secure and private designated home virtual work location
• Commitment to obtaining required internet speeds and adhering to all Work From Home requirements

Technical and Logistical Requirements:

• Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications
• Communication Tools: Ability to communicate on digital channels
• Collaboration & Scheduling: Experience with Microsoft Office 365 applications
• Systems Access & Security: Ability to log in to secure systems and manage strong passwords
• Troubleshooting & Support: Ability to resolve common technical issues independently

Anticipated Weekly Hours: 40 Time Type: Full-time Pay Range: $18.50 - $38.82