Case Manager assisting with health care coordination for patients with chronic illnesses. Managing care coordination and communication with insurance companies, healthcare providers, and patients.
Responsibilities
Manage the Care Coordination process within an assigned territory
Establish and maintain professional and effective relationships with all internal and external customers
Assess physicians’ needs and develop action plans that proactively mitigate delays in therapy
Coordinate the exchange of all patient-related information with internal and external customers
Effectively manage a database including data on each individual, their insurance, coverage approvals, on-going coverage requirements and all patient and provider interactions
Assist in obtaining insurance approvals/denials and/or appeals for therapy
Provide education to patients and health care providers regarding insurance requirements
Support special projects as requested
Requirements
Bachelor’s Degree (or equivalent) in related area with focus in Health Care, Social Work, Nursing, preferred
Minimum of three (3) years of recent experience with health care insurance benefits, relevant state and federal laws, and insurance regulations
Proven ability to assess the ethics and legality of patient care
Recent experience in the case management process is preferred
Strong verbal and written communication skills
Mediation, and problem-solving skills
Ability to speak Spanish is a plus
Benefits
Comprehensive benefits including medical, dental, vision, life, and disability insurance
401(k) plan with employer contributions
Flexible paid time off (PTO) policy for exempt employees
Eight standard company holidays and three floating holidays annually
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