Position Summary: A certified professional with strong managed care experience who can work collaboratively with team members and work independently to provide care management to HealthTexas members using Medicare Complex Care Guidelines and also support clinical assessment for Homebound or Mobility Challenged patients.
Current, unrestricted Medical Assistant Certification required.
Minimum of 1 year experience providing care to the managed care population.
Knowledge of Case Management concepts preferred.
Personal computer experience including Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum.
Experience with Milliman Care Guidelines preferred.
Experience with an electronic medical record preferred.
Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas.
Excellent telephonic customer service skills a must.
A self-starter who is successful with minimal supervision.
Exhibit leadership skills through performance, analytical thinking and process improvement.
Typing skills, at least 40 wpm.
Be able to manage a system-based approach to preventive care.
Leadership skills needed to expand the Complex Care Program.
Establish and maintain professional rapport with providers, members and other team members.
On occasion, assist the Complex Care Team with home visits for homebound patient.
Attend departmental meetings.
Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS).
Other duties assigned by the director and/or supervisor.
Health Texas Medical Group