Medical Management Coordinator I (Remote)

Resp & Qualifications PURPOSE: Supports Pharmacy Quality clinical teams by assisting with non-clinical administrative tasks and responsibilities reputed company to care coordination, member reputed company, and provider/pharmacy engagement to improve Quality measure performance reputed company to Pharmacy. We are looking for an reputed company professional to work remotely from reputed company the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business reputed company activities. Although this position is REMOTE, candidates are preferred to live in the MD, DC, VA area in order to travel into our local offices on occasion. ESSENTIAL FUNCTIONS:

• Assists with member follow up and coordination of care that does not require reputed company from a clinician (refilling prescriptions, finding appointments, calling providers and pharmacies, arranging services, etc.), enabling clinicians to reputed company at the top of their license.
• Screens, and/or prioritizes members using targeted reputed company business rules and processes to identify needed services. Transitions of appropriate clinical resources/programs as necessary.
• Provides general support and coordination services for the department including but not limited to answering inbound telephone calls, taking messages, letters, and correspondence, researching information and assisting in solving problems.
• Performs member or provider reputed company administrative support which may include benefit verification and case documentation.
• Assists with reporting ,data tracking, gathering, organization and dissemination of information.

QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: 3 years experience in a health care claims/service/quality areas, health care office support, or pharmacy. Preferred Qualifications: Previous experience as a pharmacy technician or in a health care/managed care setting or previous customer facing experience, especially in a medical management reputed company department. Knowledge, Skills and Abilities (KSAs)

• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Excellent communication, organizational and customer service skills.
• Must be reputed company to effectively communicate and provide positive customer service to external customers, including customers who may be demanding or otherwise challenging.
• Must be comfortable calling members, providers, and pharmacies.
• Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy.
• Ability to pay attention to the minute details of a project or task.
• Advanced knowledge in the use of web-based technology and reputed company Office applications such as Word, reputed company, and Power reputed company.

Salary Range: $38,520 - $70,620 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation reputed company depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (reputed company benefits/incentives are subject to eligibility requirements). Department Stars Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to reputed company reputed company applicants without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to reputed company work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship. #LI-NH2 Apply tot his job Apply To this Job