Job: Managed Care Coordinator
Duration: Months

Job Description:
Job Summary: This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.

Responsibilities: - Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients. - Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff. - Prepare, document and route cases in appropriate system for clinical review. - Initiates call backs and correspondence to members and providers to coordinate and clarify benefits. - Upon completion of inquiries initiate call back or correspondence to...