Medical Mgmt Specialist I at The Judge Group Inc.

Posted in Other 15 days ago.

Location: Coronado, California





Job Description:

Location: Coronado, CA

Description: Medical Mgmt Specialist I



This job will have the following responsibilities:

  • Responsible for providing non-clinical support to the Medical Management and/or Operations areas.

  • Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).

  • Provides information regarding network providers or general program information when requested.

  • May assist with complex cases. May act as liaison between Medical Management and/or Operations and internal departments.

  • Maintains and updates tracking databases. Prepares reports and documents all actions.

  • Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.

Qualifications & Requirements:
  • Requires a high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background.


Contact: khawkins@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com
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