Care Management Specialist II - Anchorage, AK - Hybrid | Anchorage, AK

Detailed Information

  • Location: Anchorage, AK

  • Company: Gainwell Technologies

career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary As a Care Management Specialist at Gainwell, you can contribute your skills to help our client improve the health and well-being of the Alaska Medicaid members they serve — a community’s most vulnerable. Connect your passion with purpose to remove barriers for members and resolve issues for providers to support access to care within the parameters of the program. Collaborate with other departments within

Gainwell along with Alaska Medicaid to provide specialized support to the top ten percent of members in the program. The Care Management Specialist must be able to work independently while meeting short deadlines and ensuring timely communications with all parties.

They must present themselves professionally in all interactions with all stakeholders. Here are the details of this position. Your role in our mission Contact new members in the program to welcome them, outline the program, and answer any questions to support a smooth transition. backss claim activity to look for members who need additional support regarding their needed services to align with the parameters of the program.

Outreach to educate these members on the Care Management program rules.

Collaborate with members and providers to solve escalated issues to aid in access to care. Work with members and providers to coordinate necessary care as needed. Leverage a variety of resources, or combination of resources, in order to assist the member in coordinating care. This includes recruiting providers to support the program. Maintain and record decisions, actions, and outcomes for members receiving care coordination. Calculate and report on return on investment of the program. Support other Care Management activities as needed to ensure no gaps in service. What we're looking for A minimum of two (2) years of experience in a relevant Care Coordination position in the healthcare or insurance industry with Medicaid and/or Medicare knowledge and experience strongly desired.

Familiarity with care coordination methodology and the ability to work independently and in a team setting. Experience in report analysis and presenting details. Strong oral/written communication skills. Time Managment and organizational skills. Strong analytical skills. Demonstrated strong interpersonal skills. What you should expect in this role Ability to work in a hybrid environment and attend face-to-face meetings as needed.

#LI-HYBRID #LI-LS2 The pay range for this position is 60,200 - $86,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at HMS , a Gainwell Company. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance.

We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with HMS , a Gainwell Company , an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS , A Gainwell Technologies Company at our company website and visit our Careers site for all available job role openings. HMS, a Gainwell Company is committed to a diverse, equitable, and inclusive workplace.

We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), interactionual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

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