Job Details

Case Management Support Specialist

Spanish speaking preferred. This role is fully remote with a requirement for candidates to live in Florida. The expected schedule is 8:30am-5pm EST. Top skills required include phone, computer, organized, detail-oriented, and effective multitasking. The role will provide telephone, clerical, and data entry support for the Case Management team. An additional monitor, connecting cables, and docking station are required and will be billed back to Molina at cost. There is potential for this role to extend past 3 months and/or convert to a full-time equivalent (FTE) position, although it is not guaranteed.

Duties and Responsibilities:

• Provides support to the Case Management staff performing non-clinical activities and supporting the management of the department.
• Responsible for initial review and triage of Case Management tasks.
• Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plans.
• Screens members using Molina policies and processes assisting clinical Case Management staff as they identify appropriate medical services.
• Coordinates required services in accordance with member benefit plans.
• Promotes communication, both internally and externally, to enhance the effectiveness of case management services.
• Runs reports to assist in coordination of case management needs.
• Provides support services to case management team members by answering telephone calls, taking messages, and researching information.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies.

Knowledge, Skills, and Abilities:

• Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity to concerns, proactive identification and resolution of issues to promote positive outcomes for members.
• Demonstrated ability to communicate, problem solve, and work effectively with people.
• Working knowledge of medical terminology and abbreviations.
• Ability to think analytically and to problem solve.
• Good interpersonal/team skills.
• Must have a high regard for confidential information.
• Ability to work in a fast-paced environment.
• Able to work independently and as part of a team.
• PC experience in Windows environment and accurate data entry at 40 WPM minimum.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers.

Required Education: High School Diploma or G.E.D.

Required Years of Experience: 1-3 years' experience in an administrative support role in healthcare.