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Medical Management Specialist I
Elevance HealthMedical Management Specialist providing non-clinical support to Medical Management and Operations. Gathers clinical information and acts as a liaison within the healthcare industry.
Posted 7/8/2026full-timeRichmond • Florida, Virginia • 🇺🇸 United StatesJunior💰 $20 - $31 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing clinical information and referrals within the healthcare sector, with a strong understanding of managed care, Medicaid, and Medicare processes. Proficient in customer service and maintaining accurate tracking databases while preparing detailed reports.
Highest-signal resume keywords
Managed Care UnderstandingMedicaid ExperienceMedicare ExperienceAuthorization ProcessingCustomer Service Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Tools & Technologies
Tracking Databases
Industry Keywords
Healthcare IndustryLTSS MembersClinical InformationCase ManagementNetwork ProvidersMedical ManagementOperations Liaison
About the role
Key responsibilities & impact- Gathers clinical information regarding case and determines appropriate area to refer or assign case
- Provides information regarding network providers or general program information when requested
- May assist with complex cases
- May act as liaison between Medical Management and/or Operations and internal departments
- Maintains and updates tracking databases
- Prepares reports and documents all actions
Requirements
What you’ll need- Requires a H.S. diploma or equivalent
- Minimum of 1 year experience or any combination of education and experience
- Understanding of managed care or Medicaid/Medicare strongly preferred
- Previous experience in the healthcare industry and customer service is preferred
- One year of experience working with authorizations is preferred
- Previous experience working with LTSS members or Medicaid is strongly preferred
Benefits
Comp & perks- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Paid Time Off