Program Coordinator II (Technology Specialist)
Company: Superior HealthPlan
Location: Mirando City
Posted on: February 9, 2024
You could be the one who changes everything for our 28 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
This is a remote position. Candidate must reside in Texas.Position
Purpose: Perform duties to assist in activities related to the
medical and psychosocial aspects of utilization and coordinated
- Initiate authorization requests for output or input services in
keeping with the prior authorization list. Maintain integrity of
PHI. Maintain working relationships with other departments.
Research claims inquiry specific to the department and
responsibility. Attend ongoing training and inservices as directed.
Perform tasks necessary to promote member compliance such as
verifying appointments, obtaining lab results. Assess and monitor
- Screen for eligibility and benefits. Identify members without a
PCP and refer to Member Services. Answers phone queues and faxes
within established standards. Screen members by priority for CM
- Coordinates services with community based organizations.
Attends marketing and outreach meetings as directed to represent
the plan. Produces and mails routine CM letters and program
educational material. Helps develop marketing and outreach meetings
as directed to represent the health plan.
- Train new Program Coordinators on system and usage. Guide staff
regarding benefits, authorization requirements and policy and
- Data enters assessments and authorizations into the system.
Maintains database as directed.Education/Experience: High school
diploma or equivalent; 3-5 years managed care setting, medical
office or facility setting with demonstration of medical
administration duties. Thorough knowledge of customer service,
utilization review or claims processing practices in a managed care
environment and operation of office equipment such as a personal
computer. Knowledge of medical terminology.
Licenses/Certifications: LPN license highly preferred.
Pay Range: $21.93 - $37.30 per hour
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene offers a comprehensive benefits package including:
competitive pay, health insurance, 401K and stock purchase plans,
tuition reimbursement, paid time off plus holidays, and a flexible
approach to work with remote, hybrid, field or office work
schedules. Actual pay will be adjusted based on an individual's
skills, experience, education, and other job-related factors
permitted by law. Total compensation may also include additional
forms of incentives.
Keywords: Superior HealthPlan, Laredo , Program Coordinator II (Technology Specialist), IT / Software / Systems , Mirando City, Texas
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