Assists the clinical team by building authorizations for services for patients with the goal of supporting the coordination of care such that members are able to access care in a timely manner and to remain in the least restrictive level of care appropriate to their functioning. Works under the supervision of the clinical team.

Facilitates department workflow by supporting clinical team with administrative care coordination support. Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers.

• Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
• Troubleshoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found. 
• Has current knowledge or researches availability of community resources and services and link members to appropriate services. May assist in transitions in care for hospitalized patients and makes appropriate placements, if needed.
• Assumes responsibility for self-development and career progression.
• Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.
• Assists in the mentoring and training of new Care Workers. 
• Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
• Coordinates and manages distribution of correspondence and materials to enrollees and providers. 
• Participates in operational activities, including data collection, tracking, and analysis.

The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.

Other Job Requirements

Responsibilities

Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.
For roles supporting the Chronic Pain Management SBU, understanding of Chronic Pain Management guidelines and workflows is also required.

General Job Information

Title

Careworker

Grade

19

Work Experience - Required

Work Experience - Preferred

Clinical

Education - Required

GED, High School

Education - Preferred

Associate

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$37,725

Salary Maximum:

$56,595

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.