Medical Management Specialist I/ PHRN

PHL-Taguig City-Alliance Global Toweronsitemid

Posted 2w ago · via Workday

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About this role

Position Title: Medical Management Specialist I/ PHRN Shift: Job Description: Responsible for providing non-clinical support to the Medical Management and/or Operations areas. Primary duties may include, but are not limited to: Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review). Provides information regarding network providers or general program information when requested. May assist with complex cases. May act as liaison between Medical Management and/or Operations and internal departments. Maintains and updates tracking databases. Prepares reports and documents all actions.…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

Skills match

We compare your skills against the role requirements.

Level fit

This role is mid-level. We check your trajectory against it.

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

Location fit

This role is based in PHL-Taguig City-Alliance Global Tower. We weight your proximity and willingness to relocate.

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Free · no card · written explanation included

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