Act as a point of contact within the Care Management Team to ensure members can access and navigate the healthcare system effectively.
Serves as variance coordinator for Care Management Team
Coordinates with variance committee as needed
Assist with member escalations regarding appointments/accessibility
Provide member education regarding coverage, navigation, resources
Advocate for member to support informed decision-making
Guide members through the system
Collaborates with members of the team and greater Centra system as needed
Work with TPA for members allowed variances to ensure no delays in care/claims errors
Promotes informed decision making among members
Assists medical care team in identifying members/needs and leads efforts to set priorities, identify problems requiring follow up or further medic referrals.
Other duties as assigned.
Job description can be modified or updated at any time.
Required education: Bachelor’s degree in healthcare related field
Required experience: 3 years experience in managed care including appeals/grievance, claims and member support roles.
Salary Range: $29.04-$42.12
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