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Case Specialist - Albuquerque, New Mexico | AMERIGROUP - New Mexico | Albuquerque, NM
The Case Specialist in New Mexico is responsible for managing care and
services to members. Case Specialists work in conjunction with Case
Managers to coordinate health care services by facilitating, scheduling,
and arranging a variety of treatment and health care plans.
- Coordination, authorization, fulfillment, monitoring and tracking of
health care services.
- Establish working relationships with referral sources
- Initiates and maintains contact with assigned individuals/significant
others and providers to determine members response to services.
- Coordinate home visits for Case Managers.
- Review of benefit systems.
- Identifies cases in consultation with Case Manager that would benefit
from alternative care.
- Coordinates assignments for Case Managers to facilitate timely member
evaluation.
- Arranges for services as identified by the case manager such as home
health resources, alternative long-term care placements etc.
- Knowledge of care-coordination and case management concepts.
- Identifies potential liability issues for services provided.
- Utilizes knowledge of community resources.
- Refers members to case management as indicated.
- Ensures that health care services are received as authorized by the
provider.
- Collaboratively works with other departments.
- Utilizes excellent customer service principles to assist internal
and external customers.
- Maintains member confidentiality.
- Other duties as requested or assigned.
Education
Required:
Associate Degree required (or equivalent experience)
Preferred:
- Bachelors degree preferred
- Medical Terminology preferred
Years and Type of Experience
Required:
- Minimum of (2) years working in Health Services field
- Bilingual an asset.
Other
Required:
- Computer literate
- Excellent verbal and written communication skills.
- Strong decision making skills.
- Ability to provide services in an environment that involves multiple
health care systems.
- Ability to interact with all relevant components of the health care
system.
- Ability to provide services that deal with the individuals broad
spectrum of needs
- High energy level.
- Self-starter with ability to handle multiple projects at one time.
- Appreciation of cultural diversity and sensitivity towards target
population.
Physical Requirements:
- Must be able to operate a computer.
- Must be able to operate a telephone.
In accordance with state and federal laws, employment offers are
tendered solely on the basis of qualifications without regard to race,
religion, color, national origin, age, sex, marital status, sexual
orientation, handicap (including disabled veterans) or Vietnam Era
veteran status.
AMERIGROUP administers pre-employment drug testing as a condition of
employment and a satisfactory criminal history background report.
To apply for this position, please copy and paste the following link
into your browser address bar:
http://amerigroup.contacthr.com/12978611
or submit your resume and salary requirements through our homepage at
https://va-psweb.amerigroupcorp.com/psc/agp/APPLICANT/HRMS/c/HRS_HRAM.HRS_CE.GBL?Page=HRS_CE_JOB_DTL&Action=A&SiteId=1&PostingSeq=1&JobOpeningId=9997
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