Care Management Coordinator

Process newly enrolled cases according to established workflows and maintain integrity of members' files. Receive and process requests and inquiries regarding covered or non-covered services through the interdepartmental communication system. Handle initial requests for pre-authorization of services and supplies, then coordinate and provide service authorizations to vendors. Perform accurate and timely data entry support as defined by departmental workflows and participate in scheduled team meetings. Ensure high-quality, cost-effective care for Medicaid and dual product members while acting as a liaison between members, the care management team, and vendors in compliance with CMS and DOH regulatory requirements. One year of managed care experience is required, with a college degree preferred.