Ready to be the engine that keeps care management running smoothly?
Why This Role Matters
Behind every successful care management program is someone making sure the details never slip — the reports get pulled, the invoices get reconciled, the documentation stays audit-ready. That's this role. You're the connective tissue between internal teams, external customers, and the data that keeps everything moving, and your accuracy directly protects the organization's ability to pass audits like URAC and NCQA. When service requests get answered fast and correctly, members and clients feel the difference even if they never know your name. This isn't busywork — it's the operational backbone that lets clinical teams focus on care instead of chasing paperwork. Do this well, and the whole department runs on time, on budget, and audit-ready.
What You'll Actually Do
Respond to service requests: Review and answer requests from internal and external customers accurately and on time, keeping trust intact on both sides of every interaction.
Maintain case documentation: Enter and manage case data with precision, keeping records complete and audit-ready across every file you touch.
Compile and distribute reports: Build monthly reports, maintain logs, and produce the flyers and data summaries that keep leadership and customers informed.
Manage invoices and financial tracking: Create, manage, and pull invoices to confirm payment, revenue, and expenses, keeping the department's financial picture accurate.
Organize project documentation: Keep folders and files structured and easy to navigate so anyone on the team can find what they need, fast.
Prioritize and execute daily workload: Plan and carry out assignments in an order that meets productivity, quality, and turnaround requirements every day, week, and month.
Support audit readiness: Maintain documentation and processes that hold up under external audits, including URAC and NCQA reviews.
Escalate issues appropriately: Flag department or employee concerns to the right level, using sound judgment about what needs attention now versus later.
Track projects and tasks: Participate in routine meetings and keep shared task lists and project trackers current so nothing falls through the cracks.
Protect member and client data: Maintain HIPAA compliance, uphold confidentiality standards, and complete required annual training on schedule.