Medical Management Specialist I - Kansas
Elevance Health

The Medical Management Specialist I is responsible for providing non-clinical support to the Medical Management and/or Operations areas.

Location: The ideal candidate will live within 50 miles of our Topeka, Kansas OR Olathe/Overland Park, Kansas Elevance Health location.

How you will make an impact:

• Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
• Provides information regarding network providers or general program information when requested.
• May assist with complex cases.
• May act as liaison between Medical Management and/or Operations and internal departments.
• Maintains and updates tracking databases. Prepares reports and documents all actions.
• Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.

• Requires a H.S. diploma or equivalent and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background.

• Understanding of managed care or Medicaid/Medicare strongly preferred.