Elevance Health Hiring for Medical Management Specialist I at MENDOTA HEIGHTS, Minnesota Full Time

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Medical Management Specialist I

• Job Family: Medical and Clinical

• Type: Full time

• Date Posted:Oct 30, 2023

• Req #: JR92794

Location:

• FL, MIAMI

• PA, SEVEN FIELDS

• VA, ARLINGTON

• MA, BOSTON

• IN, INDIANAPOLIS

• OH, CINCINNATI

• NY, NEW YORK

• CT, ROCKY HILL

• LA, BATON ROUGE

• CA, RANCHO CORDOVA

• MI, WIXOM

• TN, BRENTWOOD

• DC, WASHINGTON

• MD, ANNAPOLIS

• NV, LAS VEGAS

• MN, MENDOTA HEIGHTS

• TN, KNOXVILLE

• MO, SPRINGFIELD

• MO, COLUMBIA

• VA, ASHBURN

• OH, COLUMBUS

• NC, CARY

• WA, LAKEWOOD

• WI, MADISON

• NE, LINCOLN

• DE, WILMINGTON

• NE, OMAHA

• OH, SEVEN HILLS

• ID, MERIDIAN

• ID, MERIDIAN

• RI, SMITHFIELD

• MA, HINGHAM

• NC, WINSTON

• GA, ATLANTA

• DC, WASHINGTON

• IL, DEERFIELD

• VA, RICHMOND

• KY, SHELBYVILLE

• FL, ALTAMONTE SPRINGS

• NY, Lake Success

• FL, TALLAHASSEE

• KS, TOPEKA

• VA, ROANOKE

• NY, Lake Success

• CA, WOODLAND HILLS

• MD, BALTIMORE

• NJ, LAKEWOOD

• WI, Waukesha

• NJ, MORRISTOWN

• MO, JEFFERSON CITY

• TN, MEMPHIS

• OH, MASON

• NY, ALBANY

• CA, SACRAMENTO

• CA, WALNUT CREEK

• KY, LOUISVILLE

• PA, HERMITAGE

• WA, SEATTLE

• NH, MANCHESTER

• TX, GRAND PRAIRIE

• IL, CHICAGO

• NY, EAST SYRACUSE

• TX, AUSTIN

• MI, DEARBORN

• TX, DENISON

• VA, CHESAPEAKE

• CA, GLENDALE

• TN, NASHVILLE

• MN, GILBERT

• LA, METAIRIE

• NY, MIDDLETOWN

• AR, LITTLE ROCK

• IL, SPRINGFIELD

• GA, MIDLAND

• TX, HOUSTON

• VA, NORFOLK

• CA, LOS ANGELES

• CT, WALLINGFORD

• MO, ST LOUIS

• CA, COSTA MESA

• MD, HANOVER

• NJ, ISELIN

• CA, CERRITOS

• OH, MASON

• IL, CHICAGO

• CO, DENVER

• NV, LAS VEGAS

• PA, HARRISBURG

• CA, PALO ALTO

• ME, SOUTH PORTLAND

• NY, LATHAM

• OH, COLUMBUS

• HI, KAPOLEI

• GA, AUGUSTA

• IA, W DES MOINES

• MA, WOBURN

Description

Medical Management Specialist I

Location: Remote

Hours: Monday – Friday, 8 am – 4:30 pm CST

A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve. The Medical Management Specialist is responsible for providing non-clinical support to the Medical Management and/or Operations areas.

How you will make an impact:

• 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.

Minimum Requirements:

• Requires a high school diploma and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background. Understanding of managed care or Medicaid/Medicare strongly preferred.

Preferred Skills, Capabilities, and Experiences:

• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

• Previous experience in gathering data and compiling reports is preferred.

• Previous experience using Excel is strongly preferred.

* For candidates working in person or remotely in the below locations, the salary* range for this specific position is $19.65 to $35.38 *

Locations : California; Colorado; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

EEO is the Law

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• EEO Policy Statement

• Know Your Rights

• Pay Transparency

• Privacy Notice for California Residents

Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)

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