Molina Healthcare
Care Review Processor
CA, United States
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Green-card filing pattern in this occupation
Green-card follow-through: 40%
Files H-1B transfers
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About the role
- Contributes to overarching strategy to provide quality and cost-effective member care.
- Responds to requests for authorization of services submitted via phone, fax and mail according to operational timeframes.
- Contacts physician offices according to department guidelines to request missing information from authorization requests or for additional information as requested medical directors.
Responsibilities
- Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum.
- Provides telephone, clerical and data entry support for the care review team.
- Strong organizational and time-management skills, and ability to manage multiple letter queues and deadlines.
- Ability to manage multiple tasks simultaneously, and ensure quality and compliance in all produced correspondence.
- Ability to maintain confidentiality and ensure compliance with all relevant guidelines, regulations, and policies in processing of clinical correspondence.
- Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet deadlines.
- Ability to collaborate effectively with team members and internal departments.
Requirements
- Strong attention to detail, and ability to work within regulatory and internal requirements for letter generation.
- Excellent verbal and written communication skills, and ability to ensure clarity and precision in all correspondence.
- Ability to research, obtain feedback, and integrate necessary adjustments into letters to meet quality standards.
- Basic Microsoft Office suite/applicable software program(s) proficiency.
Nice to have
- To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Compensation
- Molina Healthcare offers a competitive benefits and compensation package.
This listing is sourced directly from Molina Healthcare's careers page and normalized into a canonical job model.