You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
As a Medical Case Manager, you will play a critical role in assisting patients with accessing prescribed therapies. This involves supporting healthcare providers by conducting insurance benefit investigations and managing coverage navigation. You will handle benefits requests from medical offices, communicate with insurance carriers for verification, follow up with providers on documentation, and work closely with field access managers, account managers, and sales representatives to ensure the program is effectively supported and aligned across all stakeholders.
Key Responsibilities
- Conduct benefits investigations for requests submitted by medical offices.
- Contact insurance companies to verify medical, specialty pharmacy, and prescription benefits.
- Communicate with medical offices to obtain or follow up on documentation, prior authorizations, and other case needs.
- Collaborate with Field Access Managers and Key Account Managers for program objectives alignment and support.
- Assist and support sales representatives with case-related updates and provider needs.
- Maintain accurate and timely documentation of all case activities according to program and HIPAA guidelines.
- Serve as a liaison between providers, insurance carriers, and internal teams to facilitate patient access to therapy.
- Respond promptly and professionally to case inquiries, escalating issues as necessary.
Additional Requirements
Please note: This is a pilot program, and processes may still be evolving. Flexibility and adaptability are key as changes and adjustments are likely to occur. The schedule is Monday to Friday, requiring availability from 8am-5pm or 9am-6pm. The position is on-site 100%.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
