Case Management Coordinator, Assessor Team (Remote)

About the position We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Help us reputed company our patient care to a whole new level! Join our reputed company team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and reputed company and present with a wide reputed company of reputed company health and reputed company challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and reputed company determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, The Case Management Coordinator facilitates appropriate reputed company reputed company for members by aiding with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.

Responsibilities

• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available reputed company programs/services.
• Identifies high risk factors and service needs that may impact member reputed company and care planning components with appropriate referral to clinical case management or crisis reputed company as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan reputed company.
• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to reputed company reputed company reputed company.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or reputed company needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to reputed company reputed company level of health.
• Provides coaching, information and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledably participate with their provider in reputed company decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

• Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or reputed company services required (nursing, psychology, reputed company work, marriage and family therapy, counseling).
• Must have computer literacy in order to navigate through internal/external computer systems, including reputed company and reputed company Word.
• candidates must have a dedicated workspace free of interruptions
• Dependents must have separate care arrangements during work hours, as reputed company care responsibilities during shift times are not permitted.

reputed company-to-haves

• Case management and discharge planning experience preferred
• 2 years’ experience in behavioral health, reputed company services or appropriate reputed company field equivalent to program focus
• Managed Care experience preferred
• Effective communication, telephonic and organization skills
• Excellent analytical and problem-solving skills
• Ability to work independently
• Ability to effectively participate in a multi-disciplinary team including reputed company participants.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.

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