Junior Case Management Coordinator
Junior Case Management Coordinator
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Salary Not Disclosed
1 Vacancy
Job Description
About Us:
We are a servicebased company and as a licensed thirdparty administrator we are seeking only top talent and experienced personnel in order to meet and exceed our clients expectations. Were an innovative company creating a unique experience for healthcare professionals. While many industrywide solutions exist nothing comes close to our groundbreaking approach.
About the Position
We are seeking a medically knowledgeable and customerfocused Junior Case Management Coordinator to support our care management team. In this outreachbased role you will proactively engage insured members with chronic conditions recent hospitalizations or care gaps to help facilitate timely appropriate healthcare services. This position is ideal for candidates with a clinical background.
Key Responsibilities
- Reach out to existing insured members by phone to:
- Conduct basic health assessments
- Review care needs and followup status
- Provide information on available care programs and resources
- Support case managers and RNs in implementing care plans by collecting member information and scheduling services.
- Document all member interactions and clinical findings accurately in the case management system.
- Collaborate with providers facilities and care teams to coordinate services such as DME home health or specialist referrals.
- Review member utilization and claims history to flag highrisk cases for clinical staff.
- Ensure all outreach activities follow HIPAA and health plan guidelines.
- Educate members on covered benefits preventive care and care navigation.
Job Requirements
- LPN Degree
- Medical background required
- 5 years of experience in a healthcare insurance or medical office setting.
- Knowledge of clinical workflows common medical terminology and basic chronic disease management
- Familiarity with managed care processes (e.g. authorizations referrals).
- Strong interpersonal and communication skills with a patientcentered approach.
- Comfortable conducting outreach calls in a highvolume structured environment.
- Proficient in Microsoft Office products
Bonus Points:
- We provide excellent health dental insurances vision and 401K benefits.
- We also provide of time off during the year (vacation/sick and holiday) and a pleasant working environment.
Required Experience:
IC
Employment Type
Full-Time
