Molina Healthcare Case Management Processor in Troy, Michigan

Job Description

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 principle 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. Required License, Certification, Association n/a Preferred Education Associate's Degree Preferred Experience 3 years experience in an administrative support role in healthcare, Medical Assistant preferred. Preferred License, Certification, Association n/a

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: *Healthcare Services

Organization: *Health Plans

Title: Case Management Processor

Location: MI-Troy-TROY

Requisition ID: 1806682