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Job Details

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About This Employer


Connecting employers with the talent they need + connecting healthcare professionals with the jobs they’ll love

Headquartered in New York City with 9 additional offices in New York, New Jersey, Connecticut, Massachusetts, and Florida, The Execu|Search Group specializes in the placement of healthcare professionals in full-time and temporary roles. From Registered Nursing positions to Medical Directors and Hospital Administrators, we work with some of the best healthcare facilities and are focused on connecting candidates with jobs that are tailored to their unique qualifications.  Our Health Services recruiters have achieved the Gold Seal of Approval™ for healthcare staffing services from The Joint Commission, which recognizes our dedication to providing our clients with qualified healthcare professionals.


The Execu|Search Group

CITY :

ISELIN

STATE :

NJ

COUNTRY :

USA

ZIP CODE :

08830

JOB ID NUMBER :

U1010301

POSTED :

09/03/2016

Medical Management Specialist


The Execu|Search Group


POSITION TYPE:  Temporary / Consulting

JOB SUMMARY:


Medical Management Specialist
Medical Management Specialist
Location: Iselin, NJ
Salary: $20-$21 per hour
Experience: 1. year(s)
Job Type: Temporary / Consulting
Job ID: U1010301
 
   
About the Opportunity

A health insurance company in New Jersey is looking to fill an immediate need with the addition of a new Medical Management Specialist to their staff. 08830In this role, the Medical Management Specialist will be responsible for providing nonclinical support to the Medical Management and/or Operations areas. Apply today!

Company Description

Health Insurance Company

Job Description

The Medical Management Specialist:

  • 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
  • Reviews and assists with complex case
  • Acts as liaison between Medical Management and/or Operations and Internal Departments
Required Skills
  • 1+ year of experience with an understanding of Managed Care or Medicare
  • High School Diploma
  • Microsoft Office/Suite proficient (Excel, Outlook, Word, etc.)
  • Great interpersonal skills
  • Excellent communication skills (written and verbal)
  • Strong attention to detail
  • Highly organized
  • Able to multitask efficiently and effectively
Desired Skills
  • Previous experience in Macess, Facets or Care Compass
  • Familiarity with Medical terminology