Medicaid Case Manager –
Managed Care Organization Specialist
Job Overview
We are seeking a highly skilled and experienced Managed Care Organization (MCO) Case Manager to join our law firm as a Medicaid Case Manager. The ideal candidate will have a strong background in managed care, Medicaid regulations, and case management, combined with an understanding of legal processes related to healthcare.
Responsibilities
- Manage a caseload of Medicaid beneficiaries, ensuring understand how to receive appropriate and timely care within the managed care system
- Educate clients on how to collaborate with healthcare providers, MCOs, and the legal teams to coordinate client care and resolve issues
- Evaluate comprehensive assessments of clients' health needs and develop personalized care plans
- Navigate complex Medicaid regulations and managed care policies to advocate for clients' rights and benefits
- Provide guidance with lawyer supervision on Medicaid eligibility, enrollment, and appeals processes
- Assist in preparing legal documentation related to Medicaid cases and managed care disputes
- Help clients understand how to monitor and evaluate the quality and effectiveness of services provided by MCOs
- Maintain accurate and up-to-date case records, ensuring compliance with legal and regulatory requirements
- Participate in interdisciplinary team meetings to discuss case progress and strategies
- Stay current with changes in Medicaid laws, regulations, and managed care practices
Qualifications
- Minimum of 3-5 years of experience in Medicaid case management, preferably within a managed care environment
- Thorough understanding of Medicaid regulations, managed care principles, and healthcare delivery systems
- Strong knowledge of legal processes related to healthcare and Medicaid
- Excellent communication, interpersonal, and organizational skills
- Ability to work independently and as part of a multidisciplinary team
- Proficiency in case management software and Microsoft Office Suite
- Familiarity with healthcare law and policy is a plus
Benefits
- Competitive salary commensurate with experience
- Professional development opportunities
- Paid time off and holidays
Job Type: Full-time
Pay: $47,000.00 - $75,000.00 per year
Benefits:
Medical specialties:
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Customer service: 3 years (Preferred)
Ability to Commute:
- Tampa, FL 33602 (Required)
Ability to Relocate:
- Tampa, FL 33602: Relocate before starting work (Required)
Willingness to travel:
Work Location: In person