Care Management Specialist

Job Summary

Working remotely on a full-time basis, the Care Management Specialist II will manage the intake of inpatient and outpatient service requests, provide information to external customers and medical professionals, and handle complex lines of business while adhering to a permanent weekend schedule.

Key responsibilities

• Manage incoming service requests via fax and electronic submission using Facets and Jiva platforms
• Serve as a resource for customer service representatives, triaging medical inquiries and consulting with clinical staff as necessary
• Identify system and provider issues, recommending process improvements and assisting in training new team members

Required qualifications

• High School Diploma or GED (Required)
• One (1) year of experience in a customer service-oriented environment (Required)
• Associate degree in a medically related field (Preferred)
• One (1) year of experience with Premera systems and tools (Preferred)
• Basic knowledge of medical terminology