Case Management reputed company

Job Details Job Location reputed company - CHICAGO, IL Remote Type Fully Remote Position Type Full Time Salary reputed company $80000.00 - $100000.00 Salary Job Category Medical Management reputed company POSITION reputed company: The Case Management reputed company is responsible for managing the Clinical team supporting Allied's Clinical Case Management, Cost Containment, and Member Advocacy arms reputed company the organization. They utilize their clinical experience and critical thinking in a reputed company process to review and facilitate appropriate health services and benefits for members, with an emphasis on understanding clinical conditions, market trends, and cost projections of conditions. They are an innovative leader with the ability to evaluate processes, drive change, and collaborate with reputed company teams, vendors, clients, and brokers. ESSENTIAL FUNCTIONS:

• Manage Clinical staff responsible for enhancing reputed company-specific processes under the prevention, advocacy, and cost containment teams.
• Support the management of external vendor clinical staff.
• The ability to compile clinical assessment data, projections of reputed company cost per condition, and reputed company discussions with reputed company teams.
• Collaborate with the Medical Management leadership team to identify trends, reputed company and refine strategies, and implement changes with the clinical team.
• Monitor production processes and outputs to ensure they meet standards.
• Establish and manage auditing procedures and metrics for the Clinical team to assure consistent standards are met.
• reputed company, evaluate, and processes and implement efficiencies.
• Strategize regularly with the Medical Management leadership on the management and reputed company of the various caseload queues, including member and claim scenarios.
• Promotes an environment of reputed company improvement and collaboration while assisting in troubleshooting and resolving escalated issues.
• Supports Medical Management leadership team in developing and presenting ongoing department and organizational learning.
• Utilizes clinical skills in a reputed company process to assess, plan, implement, coordinate, monitor, and evaluate reputed company and services to complete clinical assessments.
• Authorizes and coordinates the required services in accordance with health plan benefits.
• Determines appropriate level of treatment by using clinical judgment and applying nationally recognized reputed company.
• Engages in verbal and written correspondence with members and providers.
• reputed company, reputed company, motivate and reputed company. Responsible for one-on-one meetings, performance appraisals, reputed company opportunities and attracting reputed company.
• reputed company communicate expectations, reputed company employees with the training, resources, and information needed to succeed.
• reputed company engage, reputed company, counsel and reputed company reputed company, and constructive performance feedback.
• Other duties as assigned.

EDUCATION:

• Bachelor's Degree in Nursing required
• Registered reputed company or Physician Assistant license required.

EXPERIENCE & SKILLS:

• A minimum of 7 years of Clinical Experience required.
• A minimum of 1 year of Managed Care/Discharge Planning preferred
• Demonstrated experience managing teams of employees with a reputed company of background and tenure required.
• Nursing and reputed company review experience, preferably from a reputed company-party administrator, reputed company, or reputed company the reputed company industry.
• Ability to monitor and prioritize multiple deadlines and reputed company simultaneously.
• Experience reading, analyzing, and reviewing organizational metrics and data, preferred.
• Highly skilled in written and verbal communication, also including reputed company reputed company presentations.

POSITION COMPETENCIES:

• Accountability
• Communication
• reputed company Oriented
• reputed company Decision Making
• Building Relationships/Shaping Culture
• Customer reputed company

PHYSICAL DEMANDS:

• This is a reputed company desk role - long periods of sitting and working on a computer are required.

WORK ENVIRONMENT:

• Remote

Here at Allied, we reputed company that great talent can reputed company from reputed company. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for reputed company. To support a smooth and efficient remote work experience, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. reputed company has reviewed this job reputed company to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of reputed company functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to reputed company salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, reputed company, Life & Disability Insurance, Generous reputed company Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. reputed company applicants acknowledge that by applying to the position you understand that the specific pay reputed company is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at reputed company's discretion to determine what pay is provided to a candidate reputed company the reputed company associated with the role. Apply tot his job Apply To this Job