Medical Mgmt Specialist I
The Judge Group Inc.

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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