OMS-medical Care Coord

I. Conduct Primary Care Case Management (PCCM) provider and enrollment duties;
II. Manage the MaineCare Member/Provider panel reports and work with Providers and MaineCare Members as necessary to assure Members are assigned to the correct care provider;
III. Provide PCCM and Health Home Provider outreach/engagement and training and work to align the PCCM and Health Home enrollments;
IV. Coordinate MaineCare Member Education Referral Forms with MaineCare Member Services for no-shows to assure MaineCare Members are receiving necessary education related to their care;
V. Assist with MaineCare Member/Provider communications as needed and participate in the Value Based Purchasing Unti's quality improvement activities and meetings;
VI. Troubleshoot provider Health Home and PCCM referral issues; and
VII. Perform other duties and responsibilities as may be assigned from time to time
RequirementsTwo (2) year combination of education and experience in medical eligibility programs or experience in interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions or payment authorizations.
Change Healthcare is an Equal Opportunity Employer. Employment at Change Healthcare is based upon your individual merit and qualifications. We don't discriminate on the basis of race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, marital status, protected veteran status or disability, genetic characteristic, or any other characteristic protected by applicable federal, state or local law. We will also make all reasonable accommodations to meet our obligations under the Americans with Disabilities Act (ADA) and state disability laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability. Please visit Equal Employment Opportunity Posters provided by OFCCP here.
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