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Medical Management Specialist – Non-Clinical
Professional Management Enterprises (PME). Execute case management activities, including telephonic member screening, care planning, care plan implementation, service coordination, monitoring and follow-up, reassessment, case conferencing, crisis intervention, and case closure .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management activities, including member screening, care planning, and service coordination, while effectively utilizing strong organizational and communication skills to support non-clinical operations in managed care environments.
Highest-signal resume keywords
Case ManagementMember ScreeningCare PlanningOrganizational SkillsCommunication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case Management ActivitiesData GatheringReport PreparationDatabase ManagementTriage Member Needs
Soft Skills
Strong CommunicationOrganizational Skills
Tools & Technologies
Tracking DatabasesPhone Queue Management
Industry Keywords
Managed CareMedicaidMedicareNon-Clinical Support
About the role
Key responsibilities & impact- Execute case management activities, including telephonic member screening, care planning, care plan implementation, service coordination, monitoring and follow-up, reassessment, case conferencing, crisis intervention, and case closure
- Provide non-clinical support to the medical management or operations area
- Review case records and gather clinical data to determine the proper department or area for case assignment
- Receive inbound member case management calls and triage member needs via screening
- Provide community and other resources to members
- Make appropriate member referrals to clinical case managers
- Return voicemail calls received on the case management line
- Monitor and manage the case management inbound phone queue
- Provide information regarding in-network providers or general program information
- Assist with complex cases and act as a liaison between Case Management and other internal departments
- Maintain and update tracking databases
- Prepare reports and document all actions
- Exclude utilization management review activities and other clinical roles requiring interpretation of clinical information
Requirements
What you’ll need- High School Diploma or equivalent required
- Minimum of 1 year of relevant experience in managed care, Medicaid/Medicare, or a related field preferred
- Strong organizational and communication skills
- Strong computer skills are a must
- Must reside within 50 miles of Indianapolis, Indiana
- Must be available Monday-Friday, 8 am-5 pm
Benefits
Comp & perks- 🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Professional Management Enterprises (PME) Website LinkedIn All Job Openings 51 - 200 employees 🏥 Healthcare 📦 Logistics 🎖️ Defense Healthcare
- Logistics
- Defense Professional Management Enterprises (PME) is a multifaceted professional service and personnel staffing company established in 2006. As a Minority and Service Disabled Veteran Owned Business, PME operates in multiple states, partnering with major corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP. The company specializes in staffing, recruiting, and providing services across various sectors, including healthcare, information technology, and administrative support. PME is a key service provider for the Department of Defense and other Federal Government clients, and it leverages its expertise in healthcare, managed care, IT, and human capital services to deliver flexible and high-performing solutions. Medical Management Specialist – Non-Clinical Job not on LinkedIn 🔥 3 minutes ago 🇺🇸 United States – Remote 💵 $19 / hour ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior ✨ Clinical Specialist 👻 Ghost score 0% Apply Now Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
- Execute case management activities, including telephonic member screening, care planning, care plan implementation, service coordination, monitoring and follow-up, reassessment, case conferencing, crisis intervention, and case closure
- Provide non-clinical support to the medical management or operations area
- Review case records and gather clinical data to determine the proper department or area for case assignment
- Receive inbound member case management calls and triage member needs via screening
- Provide community and other resources to members
- Make appropriate member referrals to clinical case managers
- Return voicemail calls received on the case management line
- Monitor and manage the case management inbound phone queue
- Provide information regarding in-network providers or general program information
- Assist with complex cases and act as a liaison between Case Management and other internal departments
- Maintain and update tracking databases
- Prepare reports and document all actions
- Exclude utilization management review activities and other clinical roles requiring interpretation of clinical information 🎯 Requirements
- High School Diploma or equivalent required
- Minimum of 1 year of relevant experience in managed care, Medicaid/Medicare, or a related field preferred
- Strong organizational and communication skills
- Strong computer skills are a must
- Must reside within 50 miles of Indianapolis, Indiana
- Must be available Monday-Friday, 8 am-5 pm Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Clinical Specialist – Advanced Wound Care 🕒 June 25 Sol-Millennium Medical Group 201 - 500 🏥 Healthcare 🍽️ Food & Beverage 🏭 Manufacturing Website LinkedIn All Job Openings Clinical Specialist providing expert education and support for skin health in Advanced Wound Care. Collaborating with teams to enhance product adoption across various settings. 🇺🇸 United States – Remote ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior ✨ Clinical Specialist Clinical Diagnostic Specialist 🕒 June 25 ICBD Holdings 51 - 200 💼 Consulting 📣 Marketing 🏥 Healthcare Website LinkedIn All Job Openings Traveling Clinical Diagnostic Specialist conducting autism assessments across multiple clinical locations. Requires high travel commitment to various states for responsibilities in a remote role. 🇺🇸 United States – Remote 💵 $35 - $50 / hour ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior ✨ Clinical Specialist 🦅 H1B Visa Sponsor 🗣️🇪🇸 Spanish Required Clinical Clearance Specialist, RN 🕒 June 24 Charlie Health 501 - 1000 🏥 Healthcare ⚕️ Healthcare Insurance 🧘 Wellness Website LinkedIn All Job Openings Clinical Clearance Specialist (RN) responsible for reviewing escalated admissions for behavioral health treatment. Engaging with teams and ensuring clinical adequacy in virtual care for eating and substance use disorders. 🇺🇸 United States – Remote 💵 $48 - $52 / hour 💰 Seed Round on 2020-06 ⏳ Contract/Temporary 🟢 Junior 🟡 Mid-level ✨ Clinical Specialist Clinical Science Program Specialist 🕒 June 22 DAWAR CONSULTING INC 51 - 200 💼 Consulting 🏥 Healthcare 📦 Logistics Website LinkedIn All Job Openings Clinical Science Program Specialist overseeing clinical testing and laboratory services for pharmaceutical clients. Managing multiple projects and serving as a liaison with stakeholders in a regulated environment. 🇺🇸 United States – Remote 💵 $35 / hour ⏳ Contract/Temporary 🟢 Junior 🟡 Mid-level ✨ Clinical Specialist 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Remote jobs Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources About us Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Is Remote Rocketship legit? Privacy policy Terms of service Job board SEO course Remote Job Search MasterClass Resume Review AI Apply Copilot OpenClaw job finder API docs Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs