Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from your home office in the state of Wisconsin
- Supportive and collaborative work environment
- Engaging role involving interaction with members and providers
- Involvement in important health-related projects and compliance monitoring

What to Expect (Job Responsibilities):
- Process authorization requests in accordance with established guidelines and triage authorization workflow
- Assist with Case Management assignment of candidates and operational support
- Interact with members and providers via phone, fax, email, or letters regarding authorizations and case management
- Collect member or provider-specific information as requested
- Mentor new employees as needed and assist with other non-clinical projects

What is Required (Qualifications):
- High School Diploma
- Minimum of two (2) years of healthcare experience in a clinical or insurance setting
- Intermediate Microsoft Office skills
- Proficient computer and phone/faxing skills
- Ability to apply organizational, regulatory, and credentialing principles

How to Stand Out (Preferred Qualifications):
- Experience in case management or condition management
- Familiarity with CMS/Federal regulatory and NCQA standards
- Strong communication and interpersonal skills
- Ability to work independently and manage multiple tasks
- Experience with HEDIS and Health Risk Assessments

#HealthcareServices #RemoteWork #CareerGrowth #RegulatoryCompliance #CaseManagement

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