hedis program coordinator (remote cst).

　　arabi , louisiana (remote)

　　posted 3 days ago

　　job details

　　summary

　　$20.49 - $20.50 per hour

　　temp to perm

　　high school

　　category healthcare support occupations

　　referenceAB_4451171

　　job details

　　Remote/work from home, Central Standard Time zone Experience requirement: +2 years in managed care setting, HEDIS, medical office or facility setting with demonstration of medical administration duties. Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment. Knowledge of medical terminology. Education requirement: high school diploma or GED

　　salary: $20.49 - $20.5 per hour

　　shift: First

　　work hours: 8 AM - 5 PM

　　education: High School

　　Responsibilities

　　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.

　　Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan.

　　Produces CM letters and program educational material.

　　Data enter assessments and authorizations into the system.

　　The essential functions of this role include:

　　working in a smoke free environmentSkills

　　HEDIS

　　QARR

　　Qualifications

　　Years of experience: 2 years

　　Experience level: Experienced

　　Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

　　Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

　　At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

　　Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

　　Applications accepted on ongoing basis until filled.

　　get in touch

　　we are here to help you with your questions.

　　LU

　　lisa unsell

　　+1 602 200 3916 (tel:+1 602 200 3916)

　　[email protected]