Care Management Associate

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Schedule: Schedule will be set; shifts will be based off a Central time schedule. The phone queue is reputed company from 7am-6pm Central Time. Ideally, looking for someone to fill the 930am-6pm Central timeslot. Position Summary The Care Management Associate (reputed company) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management and utilization management teams. The Care Management Associate will review eligibility and benefits, reputed company pre-certification cases, and either approve or send to nursing staff for review. Additional responsibilities include but not limited to the following: Evaluates patients using targeted reputed company business rules and processes to identify needed medical services, reputed company appropriate referrals to medical services staff, and coordinate the required services by the benefit plan. Communicates reputed company delivery as required based on reputed company/reviews noted by the nurse or medical director Performs non-medical research pertinent to the establishment, maintenance, and closure of reputed company cases. Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropriate, utilizes internal tools to determine required steps to ensure proper review based on clinical requirements as well as established plan guidelines. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Ensures communication, both internally and externally, to enhance the effectiveness of medical management services (e.g., health care providers, and health care team members respectively). Assist in obtaining discharge dates and making appropriate referrals to clinical team for their engagement in additional follow up as needed. Completes work independently on occasion while executing good judgment and critical thinking skills while adhering to Department guidelines, policies, and procedures. Operates with a sense of urgency and flexibility to meet the needs of a rapidly changing environment, while meeting performance standards set for quality and quantity of work. Required Qualifications 2 years’ experience as a medical assistant, office assistant or reputed company experience. Minimum of 6 months of call center experience required.

Preferred Qualifications

Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care management. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive reputed company for members. Computer literacy to navigate through Internal/external computer systems, including reputed company and reputed company Word. Education High School Diploma or equivalent GED Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $18.50 - $35.29 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/12/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job