Enhanced Case Management Coordinator

Job Summary

Supporting department staff with administrative tasks related to medical conditions, the full-time Enhanced Case Management Coordinator will engage with members, manage audits, and facilitate communication with internal and external stakeholders in a fully remote environment.

Key responsibilities

• Facilitate reviews, referrals, and outreach for proprietary strategies while engaging with members across Medical Management products
• Document all member engagements accurately within the Microsoft CRM system and manage escalated case management questions
• Lead claims auditing and collaborate with strategic vendor partners to provide supportive services to members

Required qualifications

• Bachelor's Degree or equivalent work experience required
• 3-5 years of administrative support experience in healthcare or social services preferred
• Understanding of medical terminology and basic benefit plan design terminology
• Experience with patient-provider engagement and coordination of care
• Strong analytical skills and familiarity with Microsoft CRM systems