Post Acute Care Specialist

Job Summary

Coordinating level of care transitions, the full-time Post Acute Care Specialist - Integrated Care will manage authorization requests, communicate with stakeholders, and ensure compliance with post-acute utilization management activities in a remote setting.

Key responsibilities:

• Convert and verify information from various stakeholders into electronic records, ensuring member eligibility and benefit coverage
• Review requests and communicate changes in eligibility or coverage to providers and stakeholders
• Assist clinical teams in processing authorization requests and gathering data for reporting

Required qualifications:

• High School diploma or GED required
• Minimum of eighteen months of clinical and/or insurance experience or related healthcare education/certification required
• Managed care experience preferred
• Experience with post-acute, nursing facility, and/or HCBS waiver services preferred
• Medical Terminology Certificate preferred