Care Management Associate Resume Samples
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Care Management Associate Resume Samples
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SS
S Streich
Solon
Streich
3442 Kenyon Square
San Francisco
CA
+1 (555) 400 6939
3442 Kenyon Square
San Francisco
CA
Phone
p
+1 (555) 400 6939
Experience
Experience
Los Angeles, CA
Care Management Associate
Los Angeles, CA
Schroeder LLC
Los Angeles, CA
Care Management Associate
- Supports the administration of the hospital care, case management and quality management processes in compliance
- Support the Development and Implementation of Care Plans
- May assist in the research and resolution of claims payment issues
- With various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA)
- Sends Care Management letters
- Multi-tasks to accomplish workload efficiently
- Care Management Team Intake
present
Los Angeles, CA
Care Management Associate
Los Angeles, CA
Abernathy, Collins and Leffler
present
Los Angeles, CA
Care Management Associate
present
- Performs Care Management support services based on members established care plans and at direction by the members assigned care manager
- Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs
- Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems
- Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other
- Performs non-medical research pertinent to the establishment, maintenance and closure of open cases
- Performs duties associated with member health and wellness; Multi-tasks to accomplish workload efficiently
- Performs non-medical research pertinent to the establishment, maintenance and closure of open cases ( )
Education
Education
Associate’s Degree
Associate’s Degree
Baylor University
Associate’s Degree
Skills
Skills
- 2-4 years experience as a medical assistant, office assistant
- 2-4 years experience in customer service is desired
- Some call center experience is desired
- 2-4 years of Customer Service experience
- 1+ years of experience working in a medical setting
- 2+ years experience as a medical assistant, office assistant
- 2+ years experience in customer service is desired
- 1+ years of customer service experience
8 Care Management Associate resume templates
Read our complete resume writing guides
1
Care Management Associate Resume Examples & Samples
- Responsible for initial review and triage of Care Team tasks
- Identifies principle reason for admission, facility, and member product to correctly apply intervention assessment tools
- Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan
- Monitors non-targeted cases for entry of appropriate discharge date and disposition
- Identifies and refers outlier cases to clinical staff
- Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs
- Support the Development and Implementation of Care Plans
- Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services
- Promotes communication, both internally and externally to enhance effectiveness of medical management services
- May assist in the research and resolution of claims payment issues
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
- Adheres to Compliance with PM Policies and Regulatory Standards
- Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems
- 2-4+ years of professional experience as a medical assistant, office assistant, or other role in the healthcare/medical field required
- Proficient computer skills preferred
- Strong customer service skills required
- Familiarity with basic medical terminology and concepts used in care management preferred
- Effective communication, telephonic and organization skills required
2
Care Management Associate Resume Examples & Samples
- Strong customer service skills required to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members
- Computer literacy in order to navigate through internal/external computer systems, including Outlook and Microsoft Word. -Ability to effectively participate in a multi-disciplinary team including internal and external participants
- Effective communication, telephonic and organization skills
3
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant, office assistant or other clinical experience; Required
- Strong customer service skills to coordinate service delivery, including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for customers; Required
- Computer literacy - Microsoft Office
- Familiar with basic medical terminology; Required
4
Care Management Associate Resume Examples & Samples
- 2-4+ years experience in Customer Service (call center or in-person) experience required
- 1-3+ years of direct Call Center experience preferred
- 1-3+ years experience in a medical or healthcare setting preferred
5
Care Management Associate Resume Examples & Samples
- 1-3 years of healthcare experience is required
- 1-3 years of customer service experience is required
- Strong computer skills are required
6
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant, office assistant or other clinical experience is preferred
- 2-4 years in a call center environment is preferred
- 1 year minimum of healthcare experience is required
7
Care Management Associate Resume Examples & Samples
- 2-4 years experience in customer service; Desired
- Some call center experience; Desired
- 1-3 years experience in a medical setting; Preferred
- Microsoft Office and Computer Comfort; Strong Preference
- Motivational interviewing; Preference
- 1-3 years administrative experience; Strong Preference
8
Care Management Associate Resume Examples & Samples
- At least one years' experience as a medical assistant or office assistant.is required
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members
- Computer literacy in order to navigate through internal/external computer systems, including Microsoft Excel and Microsoft Word
- The ability to effectively participate in a multi-disciplinary team including internal and external participants
- Familiarity with basic medical terminology and concepts used in care management is highly preferred
- Effective communication, telephonic and organization skills are a must!
9
Care Management Associate Resume Examples & Samples
- We are looking for Care Management Associate to join our Team in High Point NC
- Answering incoming calls from providers or members regarding precertification or registration for surgical procedures
- Coordinating care with nurses
- Retrieving, sorting tasking electronic clinical records to appropriate resource
- Timely documentation in on-line system
10
Care Management Associate Resume Examples & Samples
- 2+ years in a healthcare management setting
- Familiarity with Medicare and Medicaid is preferred
- Local travel of up to 10 - 25% may be possible. Requires a personal vehicle or dependable transportation, valid DL and insurance
11
Care Management Associate Resume Examples & Samples
- Minimum of 2-4 years of experience as a Medical Assistant or Office Assistant with knowledge of medical terminology and concepts used in care management required
- Strong customer service skills to coordinate service delivery, including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members required
- Computer literacy in order to navigate through internal/external computer systems, including Microsoft Excel and Word required
- Ability to effectively participate in a multi-disciplinary team including internal and external participants required
- Effective communication (written, verbal and telephonic) and organization skills required
12
Care Management Associate Resume Examples & Samples
- Minimum 2-4 years experience as a medical assistant or office assistant in a medical office
- Strong communication skills - articulate, professional and personable
- Team player, able to work in a collaborative environment
13
Care Management Associate Resume Examples & Samples
- Prior customer service is required
- Medical terminology is preferred
- Call Center experience is preferred
- 4 year/ associates degree preferred and/or equivalent work experience
14
Care Management Associate Resume Examples & Samples
- Minimum of 2-4 years experience as a medical assistant or office assistant in a medical office
- Strong customer service skills to coordinate service delivery including attention to members and providers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members
- Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word
- Ability to effectively participate in a multi-disciplinary team including internal and external participants
- Familiarity with basic medical terminology and concepts used in care management
15
Care Management Associate Resume Examples & Samples
- Minimum of 2-4 years experience as a medical assistant, office assistant in a medical setting, patient registrar, nursing assistant, medical scheduler, or similar required
- Familiarity of medical terminology required
- Proficient computer skills (Microsoft Office suite) required
- Ability to multi-task required
16
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant or office assistant' Required
- Medical terminology knowledge; Required
- Strong customer service skills to coordinate service delivery including attention to customers,
- Sensitivity to issues,
- Proactive identification and resolution of issues to promote positive outcomes for members
- Computer literacy in order to navigate through internal/external computer systems, including
- Excel and Microsoft Word
- Ability to effectively participate in a multi-disciplinary team including internal and external
- Participants
17
Care Management Associate Resume Examples & Samples
- Minimum of 2 years of experience as a medical assistant or office assistant in a medical setting required
- Familiarity with basic medical terminology and concepts used in care management required
- Computer literacy in order to navigate through computer systems (especially Microsoft Excel and Word) required
18
Care Management Associate Resume Examples & Samples
- Strong customer service and people skills are required
- 2-4 years experience in customer service is desired
- Some call center experience is desired
19
Care Management Associate Resume Examples & Samples
- Medicaid Knowledge; Required
- Knowledge and experience with Medicaid application and recertification process; Required
- Experience with ancillary service authorizations; Required
- Bilingual (English and English or Spanish); Preferred
- Experience using Microsoft Office (Word, Outlook, Excel); Required
20
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant or experience in a medical office is required
- Computer literacy is needed, as well as the ability to multi-task and work in a fast paced environment: Required
- Experience with data entry, medical terminology, customer service is required
- Experience with Microsoft Excel and Outlook is required
- Experience with electronic health records is required
- Bilingual is preferred
- Experience with the MLTSS population is preferred
21
Care Management Associate Resume Examples & Samples
- Bilingual in English and Spanish required
- Minimum of 2-4 years of experience as a Medical Assistant or Office Assistant required
- Phone-based customer service experience required
22
Care Management Associate Resume Examples & Samples
- Responsible for initial review and triage of Care Team tasks. (*)
- (*)
- Screens patients using targeted intervention business rules and processes to identify needed medical services, make
- Appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit
- Plan. (*)
- Monitors non-targeted cases for entry of appropriate discharge date and disposition. (*)
- Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff. (*)
- Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other
- Specialty Programs. (*)
- Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed. (*)
- Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most
- Appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating
- Providers and services
- (e.g.,health care providers, and health care team members respectively) (*)
- Performs non-medical research pertinent to the establishment, maintenance and closure of open cases (*)
- Provides support services to team members by answering telephone calls, taking messages, researching information
- And assisting in solving problems. (*)
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and
- Accreditation requirements. (*)
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality. (*)
- Supports the administration of the hospital care, case management and quality management processes in compliance
- With various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA)
23
Care Management Associate Resume Examples & Samples
- Minimum of 2-4 years experience as a medical assistant or office assistant in a medical setting
- Managed Long Term Care (MLTC) experience and knowledge of the business is a strong preference
- Fully-Integrated Dual Advantage (FIDA) is preferred
- Fluency in English and Mandarin preferred
24
Care Management Associate Resume Examples & Samples
- Minimum of 1-3 years demonstrated excellent customer service skills required
- Efficient computer skills required
- Multi-tasking skills (ability to navigate multiple screens and systems while on the phone) required
- Articulate and professional phone presence; able to handle escalated cases
- Ability to perform sedentary work involving significant periods of sitting, talking, hearing and keying required
- Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor
- Experience as a Medical Assistant or Office Assistant preferred
25
Care Management Associate Resume Examples & Samples
- Strong telephone presence & communication skills required
- Role requires sedentary work involving significant periods of sitting, talking, hearing and keying
- Ability to work until 10pm approximately once every 6 to 8 weeks is required
- 2-4 years experience as a medical assistant or office assistant preferred
26
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant, office assistant is highly preferred! (medical terminology)
- Values attendance and punctuality
- Able to work in multiple web based applications simultaneously
- Demonstrates strong customer service skills
- Knowledge of Microsoft Office products
27
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant, office assistant; Preference
- Knowledge of General Medical Terminology; Required
- Insurance Knowledge; Preference
- 2-4 years Customer Service; Required
28
Care Management Associate Resume Examples & Samples
- At least 2-4 years experience as a medical assistant, office assistant, or insurance (health) experience is needed!
- Ability to speak clearly and maintain a professional demeanor in stressful situations
- Strong Administrative and Computer skills required. (Written and Verbal communication skills)
- Microsoft Word, Excel and Outlook required
- Managed Care/ Insurance background a plus! (medical knowledge)
- Must have a pleasant and energetic attitude
29
Care Management Associate Resume Examples & Samples
- 2-4 years experience as a medical assistant, office assistant, any medical terminology highly desired!
- (could include hospital, doctor's office, long term care, expereince)
- At least 2 years of working in an office environment is needed
- Experience MS Word and Outlook are required, Excel would be a plus!
- Self motivation and high organizational skills are a must!
30
Care Management Associate Resume Examples & Samples
- Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff
- Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed
- Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively)
- Performs non-medical research pertinent to the establishment, maintenance and closure of open cases
- Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures
- Minimum of 2-4+ years experience as a medical assistant, office assistant, or related healthcare/medical role required
31
Care Management Associate Resume Examples & Samples
- Computer literacy in order to navigate through internal/external computer system; Requirement
- 2-4 years experience as a medical assistant, office assistant; Strong Preference
- Medical terminology knowledge; Strong Preference
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members; Preference
32
Care Management Associate Resume Examples & Samples
- 2+ years experience as a medical assistant, office assistant or other clinical experience
- Strong customer service skills to coordinate service delivery, including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for customers
- Familiar with basic medical terminology
