What are the responsibilities and job description for the Case Management Processor position at Molina Healthcare Group?
Job Description
JOB DESCRIPTION
The Case Management Processor will be working 100% remote in an outbound call environment (Must reside in the state of MI). Our Case Management Processor will be working with our MI Medicaid members that were recently discharged from the hospital. This individual will be making outbound calls to our members to complete health risk assessments and answer any member questions. We are looking for candidates with outbound call center experience, excellence customer services, and ability to toggle back and forth between multiple screens and databases.
Home office with internet connectivity of high speed required.
Will be required to go into the Troy MI office when needed for team Meetings or Trainings (Preference is 60 miles distance to office)
Monday – Friday 9:30 AM to 6 PM EST (No weekends or Holidays)
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Provides telephone, clerical, and data entry support for the Case Management team.
- Responsible for initial review of assigned case levels to assist in Case Management assignment.
- Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
- Schedules member visits with team members as needed.
- Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify appropriate medical services.
- Coordinates required services in accordance with member benefit plan.
- Promotes communication, both internally and externally to enhance effectiveness of case management services.
- Processes member and provider correspondence.
JOB QUALIFICATIONS
Required Education
HS Diploma or GED
Required Experience
1-3 years’ experience in an administrative support role in healthcare.
Preferred Education
Associate degree
Preferred Experience
3 years’ experience in an administrative support role in healthcare, Medical Assistant preferred.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Info
Job Identification: 2031114
Job Category: Clinical
Posting Date: 2025-04-14T15:27:32 00:00
Job Schedule: Full time
