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Care Management Specialist II at Premera Blue Cross - ApplyBlast

Care Management Specialist II

Premera Blue Cross

1 day ago

2.9 on Glassdoor

Remote

Full Time

Medior

0 applicants

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About this role

The Care Management Specialist II works independently to manage inpatient and outpatient service requests, providing information to external customers and medical professionals regarding medical services inquiries. This role involves applying knowledge of complex lines of business to respond to clinical review questions and requests from providers and facilities. The position requires a permanent weekend schedule and focuses on processing service requests while adhering to regulatory standards.

Responsibilities

Manage inpatient and outpatient service requests via fax and electronic submission
Process prospective utilization management requests and pre-service reviews
Triage medical inquiries and consult with clinical staff as appropriate