Care Management Associate

An established healthcare organization supporting managed care populations is seeking a Care Management Associate to provide coordinator and administrative support for members enrolled in Managed Long Term Care (MLTC) and MAP programs. This role supports care coordination activities and serves as a key point of contact for members, internal teams, and external vendors.

Responsibilities:

• Provide coordinator support to members within MLTC and MAP lines of business
• Handle inbound member calls through the call center and place outbound calls as needed
• Manage inbound requests received via fax
• Complete missing or inconsistent information in member documentation
• Maintain accurate member files and track membership status
• Serve as liaison between the organization and HHA, PCS, and CDPAS vendors regarding member benefits
• Enter prior approvals and service authorizations into internal systems based on program benefits
• Notify vendors of service start dates
• Track and monitor member admissions to hospitals, nursing homes, ER visits, and unexpected outcomes
• Track short-term member absences from geographic areas
• Monitor and report quality-related metrics as identified by team leadership
• Identify and report common trends during member interactions
• Notify Care Managers when members cannot be reached
• Perform additional tasks as assigned by Team Lead or management

Qualifications:

• High School Diploma or High School Equivalency required
• Minimum one year of full-time experience in direct consumer contact
• Prior customer service or call center experience required
• Understanding of medical terminology preferred
• Knowledge of ICD-10 and CPT-4 codes preferred
• Prior managed care experience preferred

Please note that the salary range and/or hourly rate range of $23.00 - $25.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity).

For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool.

At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.