MANAGED CARE CASE MANAGER
Job description
General Duties
Managed Care Case Manager provides supportive services to NEON patients to ensure comprehensive, coordinated specialty care. Works closely with providers to maximize follow through with treatment plans, specialty referrals and hospital discharges. Communicates with Medicaid Managed Care and Private insurance plans to ensure compliance with outcome measures. Empowers patient self-management of their care and promotes Patient Centered Medical Home Model of Care.
Education
Bachelor's degree in Health or Social Sciences, Business, Health Care Administration, Public Health or Health Education.
Associate's degree considered with additional relevant experience.
Minimum Qualifications
Excellent verbal and written communication skills as well as good listening skills;
Knowledge of health disparities and chronic disease management treatment resources;
Strong organizational skills, attention to detail and timely documentation required;
Proven critical thinking and problem solving skills:
Knowledge of Ohio Medicaid Management Care Plans;
1-2 years at hospital, outpatient clinic or insurance plan navigating the specialty referral process; as well as experience with HEDIS outcome measures and the requirements need to provide quality healthcare for patients with complex and chronic health issues.
Technical Skills
Demonstrated knowledge and proficient in the use of Microsoft Office and Outlook.
Ability to become proficient in the use of NextGen software.
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