Case Management Associate Analyst
Case Management Associate Analyst
Tailored Management
Bloomington, MN
See who Tailored Management has hired for this role
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:
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
- 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
- Empathy,
- Strong technology skills
- Multi-tasking
- 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
- English - Read Write Speak
-
Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Business Development and Sales -
Industries
IT Services and IT Consulting, Software Development, and Financial Services
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