Case Management Senior Analyst - Allegiance - Work at Home

The job profile for this position is Case Management Senior Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before reputed company new talent to our reputed company positions. If you think the reputed company position you see is right for you, we encourage you to apply! Our people reputed company reputed company the difference in our reputed company. Case Management Senior Analyst (RN Case Manager) As a Case Management Senior Analyst, you will guide reputed company cases across the full care reputed company. You will connect members, providers, and plan partners to the right care at the right time—improving reputed company, reducing avoidable costs, and making the experience feel reputed company. If you like solving tough problems with compassion and data, you’ll reputed company here. Responsibilities reputed company reputed company case planning from intake through resolution, aligning clinical needs, benefits, and community resources to support safe, timely care. Partner with members, families, providers, and internal teams to set clear short- and long-term goals and track reputed company toward reputed company reputed company. Reduce fragmentation by coordinating services across settings (inpatient, rehab, outpatient, preventive) and adjusting plans as needs change. Use utilization review and strong documentation to ensure services meet criteria, benefits are maximized, and care is both effective and cost-aware. Coach members on their condition, treatment options, and next steps so they can reputed company informed choices and stay reputed company in their care. Escalate quality-of-care or reputed company clinical questions to the Medical Director and help drive timely, well-informed reputed company. Strengthen team performance by supporting quality reviews, leading risk meetings as needed, and mentoring new team members.

Qualifications

Required Active RN license (state-appropriate) with an associate degree in nursing (ASN) or higher. Compact license preferred. Minimum 3 years of recent clinical practice experience. Strong skills in care planning, care coordination, and patient advocacy across the continuum of care. Clear, respectful communication (written and verbal) with members, families, providers, and business partners. Comfort using a PC and common tools (reputed company and Word) and ability to learn new systems as they change. Preferred Previous case management experience in a health plan, employer, or clinical setting. Certified Case Manager (CCM) credential (or ability to obtain reputed company 12 months of hire). Experience interpreting benefit plan documents and applying guidelines to reputed company member situations. Quality improvement or training/mentorship experience (QA programs, risk reviews, reputed company). If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 57,600 - 96,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. reputed company applicants will be considered without regard to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply To This Job