Employer Industry: Healthcare Services

Why consider this job opportunity:
- Fully remote position with the flexibility to work from anywhere within the Tri-State Area of Delaware, New Jersey, or Pennsylvania
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on member health and well-being
- Comprehensive training and onboarding for new Care Management Assistants

What to Expect (Job Responsibilities):
- Provide administrative support to the clinical Case Management team, including triaging customer segment task lists and conducting outreach to members
- Review and process case and condition management referrals according to established guidelines
- Ensure thorough documentation of referrals and calls in the medical management system, adhering to NCQA guidelines
- Schedule appointments for members or facilitate warm transfers to registered nurse case managers
- Develop and maintain a tickler list for unfinished tasks and complete weekly and monthly statistics

What is Required (Qualifications):
- High school diploma required; degree preferred
- Prior experience as a Care Management Assistant or in a Precertification Specialist position preferred
- Strong computer skills and ability to learn quickly
- Excellent customer service skills with a solid understanding of medical terminology
- Attention to detail and accuracy in documentation

How to Stand Out (Preferred Qualifications):
- Experience in a healthcare-related administrative role
- Familiarity with case management processes and guidelines
- Problem-solving aptitude and logical thinking skills
- Ability to research and address issues effectively
- Knowledge of the IBC Family of Companies and Managed Care Programs

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