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Case Management Analyst
Ref No.: 20-02357
Location: Eden Prairie, Minnesota
Case Management Analyst
Location: Eden Prairie, MN
Schedule: Training schedule will be 9am - 5:30pm (CST) for the first two months, then after training schedule will move to 10:30am - 7:00pm CST
Pay: $20.15
Start: 5/26/2020

The Behavioral Operations Support Team Care Coordinator position is a fast-paced position that includes numerous tasks including, but not limited to:
  • Create and process Administrative and Medical Necessity determination denial letters to facilities and members ensuring accuracy with documentation and compliancy with state and federal guidelines for multiple lines of business including CAMS, TruCare, CCMS, and QANI.
  • Partner with internal matrix teams to ensure legal, Federal and State Mandates are in compliance and NCQA & URAC accreditation guidelines are met.
  • Responsible for tracking and sending Lack of Information letter requests.
  • Utilize Excel, Daily Stats, and Sharepoint site to create and send out morning report, which details case assignment and caseloads for case managers.
  • Complete monthly reporting and stats.
  • In control of managing the precert bin and assigning cases to case managers and care coordinators in an expeditious manner.
  • Accountable for the TruCare provider add process.
  • Integrate with other Care Coordinator teams to support and reinforce the day to day needs.
  • Additional tasks and reports as assigned.

Skills:
  • At least 2 years of experience in behavioral health services setting
  • Strong verbal, written and interpersonal communication skills
  • Effective listening and analytical skills
  • Extremely detail oriented and proficient organizational skills
  • Strong ability to multi-task and exhibit excellent prioritization skills
  • Works well in a virtual team environment
  • Experience working on multiple projects simultaneously under tight deadlines
  • Technical knowledge of automated databases, tracking systems, spreadsheet applications
  • MUST BE PROFICIENT in Excel, Word and other Microsoft Products
  • System familiarity with TruCare, CAMS, HC ICMS, QANI and Oneview is preferred
  • Ability to manage change effectively and assist in leading others through the change process
  • Phone experience in talking with members and providers Stronly Preferred.

Education:
Bachelor’s degree required