Program Coordinator 1 (Remote with Restrictions)

REMOTE WITH RESTRICTIONS - Must live in Delaware State

Contract-to-hire

This role offers medical administration professionals the ability to work alongside a leader in managed care solutions! Further explore this exciting opportunity below

Benefits of this Role :

• Exposure : Working for one of the largest Medicaid managed care organizations in the country!
• Work / Life Balance : No weekend work, traditional business hours and remote log in!
• Benefits : Pay cycle weekly Medical, Dental & Vision benefits offered.

Qualifications :

• Medical Customer Service background
• 2-3 years managed care setting
• Outlook email, Teams, Microsoft office, Spreadsheets skills
• Reliable internet - will be tested*
• Must be located in the state of Delaware!

Job Overview :

• Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.
• Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results.
• Assess and monitor inpatient census.
• Screen for eligibility and benefits.
• Identify members without a PCP and refer to Member Services.
• Screen members by priority for case management (CM) assessment.
• Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.

Work Environment

• Remote from home- DE
• 8 : 00 AM to 5 : 00 PM(EST)

Apply to learn more!

About TEKsystems :

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity.

As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change.

That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Last updated : 2024-05-24