Case Management Associate Analyst

Title: Case Management Associate Analyst

Location: 100% Remote-

Working Hours: Candidate can be located in any time zone as long as they can commit to the CST hours for the role. 10:30 -7 CST.

Initial Assignment Length: 3 Months Contract

A global health insurance provider whose mission is to improve the health, well-being, and peace of mind of those the company serves. Become a part of this ever-growing, deeply caring, and collaborative healthcare industry leader today!

Description:

• Complete scheduling of peer reviews for all lines of business, which includes building and verifying template information, making outbound/receiving inbound calls from facilities and providers to schedule reviews, coordinating MD/PHD calendars, documenting in the case, assigning for follow-up, and notifying Care Managers
• Provide verbal determination to facilities and providers on results of peer reviews
• Complete follow-up on cases after peer review including creating alternative level of care authorizations, discharge planning, and appeal requests
• Utilize workflows efficiently to ensure accurate documentation and adhere to compliance guidelines.
• Responsible for management of MD Scheduling mailbox.
• Work closely with internal matrix partners to ensure legal, federal, and state mandates are in compliance, and NCQA and URAC accreditation guidelines are met
• Proficiently communicate with matrix partners including appeals coordinators, case managers, medical directors, individual HCP's, and facilities
• Provide exceptional customer service, collaborating closely with matrix partners, to ensure each case is completed and effectively communicated to the customer and facility in a timely manner
  
  

Skills:

• At least 2 years of experience in behavioural health services setting
• Strong verbal, written, and interpersonal communication skills
• Effective listening and analytical skills
• Extremely detail oriented and proficient organizational skills
• Strong ability to switch-task and exhibit excellent prioritization skills
• Experience working on multiple projects simultaneously under tight deadlines
• Technical knowledge of automated databases, tracking systems, spreadsheet applications
• Ability to manage change effectively and assist in leading others through the change process
  
  

3 Non-Negotiable Skills:

• Empathy,
• Strong technology skills
• Multi-tasking
  
  

Education:

• Bachelor's degree in mental health field or psychology/social work-related field required (can also include: family communications, health coaching, community/public health or other related major).
• This is a non-clinical role and does not require a license
• Previous customer service experience or related position
  
  

Languages:

• English - Read Write Speak
  
  

Should you accept an offer for a contract opportunity with our client, the following pre-employment items will be required: 7-year criminal background check, which will include verifying your highest level of education completed and your employment history for the last 7 years, and a urine drug test analysis (does not look for marijuana/THC). You may be required to provide documentation (copy of your diploma or licenses, W2's or Pay stubs) to help us verify this information.