Analyst, Case Management Specialist (Remote)

Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. This is a full-time remote role reputed company to candidates throughout the reputed company. Hours for this position are Monday-Friday 8:00am - 5:00pm in time zone of residence. Program reputed company: 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 reputed company on our Dual Eligible Special Needs Plan (DSNP) 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 DSNP to change lives in new markets across the country. Position reputed company/Mission: 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 providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. reputed company Components • Evaluation of Members: -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 reputed company 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 reputed company 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. • Enhancement of Medical Appropriateness and reputed company of Care: - 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 reputed company of care issues through established channels. • Utilizes negotiation skills to secure appropriate reputed company 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 reputed company and knowledgably participate with their provider in reputed company decision-making. • Monitoring, Evaluation and Documentation of Care: - Utilizes case management and reputed company management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required Qualifications: • 3+ years experience in health-reputed company field Preferred Qualifications: • CRC, reputed company, CRRN, COHN, or CCM certification • Medicare and reputed company experience • Managed care experience • Experience working with geriatric special needs, behavioral health and disable population • Knowledge of assessment, screenings and care planning • Bilingual (English/Spanish; English/Creole) Education: • Bachelors Degree or equivalent experience required Pay reputed company The typical pay reputed company for this role is: $19.52 - $40.10 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible employees may enroll in reputed company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. reputed company provides a fully-reputed company term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous reputed company-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy reputed company Time Off (“PTO”) or vacation pay, as reputed company as reputed company holidays throughout the calendar year. Number of reputed company holidays, reputed company time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.reputed company.com/benefits We anticipate the application window for this opening will reputed company on: 05/11/2024 Apply Job! For more such jobs please click here!