Clinical LTSS Service Care Coordinator J01107

Position Title: Clinical - LTSS Service Care Manager

Location: Remote -TX

Schedule: 8am 5pm with possible OT

• The Specialty Authorization Team consists of the processing of authorizations and follow-ups for DME MHM DAHS and reductions/denials in which we are now at a 1 BD TAT for the processing of SK/SH/MMP authorizations.
• We utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions.
• The team continues to experience high authorization volumes.
• We work together like a family rather than co-workers in which helps facilitate the best care for those we serve by being committed flexible and compassionate to enhance the lives of each and every Member.
• Daily check in & communication via group IM(s)
• Daily production logs must be completed and emailed to designated individual no later than 9am next business day
• Multi-tasking with multiple monitors and applications
• Utilize work guides and or resources
• 97% Quality (Audits)
• 98% Production

• LPN LVN or LCSW preferred

• 2 years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. Other state specific requirements may apply.

• Microsoft Outlook Microsoft Teams Zoom Microsoft Word Microsoft Excel SharePoint Internet
• 2 years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions.