Medical Management Coordinator I

About This Role

The Medical Management Coordinator I supports clinical teams and care managers by handling non-clinical tasks related to care coordination, ensuring timely and appropriate care for members. This role involves frequent communication with members, providers, and care teams.

Responsibilities

• Provide internal and external customer support for care management inquiries from members, providers, and other customers
• Assist with member follow-up and coordination of care that does not require clinician intervention, including post-discharge monitoring and arranging services
• Screen and prioritize members using targeted intervention business rules to identify needed services and transition to appropriate clinical resources/programs
• Provide general support and coordination services for the department, including answering telephone calls and assisting in problem-solving
• Assist with reporting, data tracking, gathering, and organization of referrals

Requirements

• High School Diploma or GED
• 3 years experience in a health care or health insurance setting
• Ability to effectively participate in a multi-disciplinary team
• Excellent communication, organizational and customer service skills
• Knowledge of basic medical terminology and concepts used in care management
• Knowledge of standardized processes and procedures for evaluating medical support operations business practices
• Excellent independent judgment and decision-making skills
• Ability to pay attention to minute details
• Advanced knowledge in the use of web-based technology and Microsoft Office applications such as Word, Excel, and PowerPoint

Qualifications

• High School Diploma or GED
• 3 years experience in a health care or health insurance setting

Nice to Have

• Previous experience in a health care/managed care setting
• Previous customer facing experience, especially in a medical management related department

Skills

* Required skills