Care Management Specialist I.

Location

Anchorage, AK | United States

Job description

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at HMS , a Gainwell Company carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

As a Care Management Specialist at Gainwell, you can contribute your customer service and analytical skills to help our client improve the health and well-being of the members they serve — our community’s most vulnerable. The Care Management Specialist collaborates with Alaska Medicaid, its members, and providers to ensure policies are followed and good service is provided. The Care Management Specialist must be able to work independently while meeting short deadlines and ensuring timely communications with all parties. They must present themselves professionally in all interactions with all stakeholders. Here are the details of this position.​

Your role in our mission

• Handle incoming calls related to Fraud/Abuse Complaints and the Care Management program targeting first-call resolution where possible.
• Research complaint allegations and present recommendations to the client.
• Generate reporting outlining activities that have occurred related to complaints and CMP interactions.
• Outreach to recipients and providers to educate them on program rules as needed.
• Create and distribute coupons for the CMP program members. 
• Investigate concerns with Explanation of Medical Benefits and resolve issues if applicable.
• Maintain a master Care Management Plan table including details of recipients in the program.
• Maintain and record outreach, communications with the client, and activities to ensure reporting is accurate and timely.
• Support other Care Management activities as needed to ensure no gaps in service.

What we're looking for

• A minimum of two (2) years of customer service experience is required, with Lock-In or relevant care coordination experience in the healthcare industry preferred.
• Experience in data entry, report analysis, and presenting details.
• Strong oral/written communication skills.
• Time Management and organizational skills.
• Strong analytical skills.
• Demonstrated strong interpersonal skills.

What you should expect in this role

• Ability to work in a hybrid environment and attend face-to-face meetings as needed.
• #LI-HYBRID
• #LI-LS2

The pay range for this position is $44,800 - $64,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at HMS , a Gainwell Company . You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with HMS , a Gainwell Company , an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS , A Gainwell Technologies Company at our  company website and visit our  Careers site for all available job role openings.

HMS, a Gainwell Company is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

Job tags

Salary