Medical Mgmt Specialist I
The Judge Group Inc.

Job Info

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Location: Eagan, MN
Description: Medical Mgmt Specialist I - Eagan MN Market

Job Summery:

• Responsible for providing non-clinical support to the Medical Management and/or Operations areas.

Primary duties may include, but are not limited to:

• Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
• Provides information regarding network providers or general program information when requested. May assist with complex cases.
• May act as liaison between Medical Management and/or Operations and internal departments. Maintains and updates tracking databases.
• Prepares reports and documents all actions.
• Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.
• Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Required Skillset and Experience:

• Proficient in MS Office products, in particular Excel.
• Previous knowledge or experience with health insurance operations.
• Ability to multi-task and have multiple screens and windows open at one time.
• Comfortable with telework environment since not at physical location at time of posting.
• Good customer service skills with individuals across teams in the organization and outside parties.
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Education:

• Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.

Anticipated work schedule:
8:00am-5:00pm CST

Contact: mmabry@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com

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