AnalystCase Mgt
About the position
Responsibilities
• Coordinate, document, and communicate all aspects of the utilization/benefit management program.
• Conduct comprehensive evaluations of referred members' needs and eligibility.
• Recommend approaches to case resolution and meeting members' needs by evaluating their benefit plans.
• Identify high-risk factors and service needs that may impact member outcomes and care planning components.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Present cases at case conferences for multidisciplinary review to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services for members.
• Utilize influencing and motivational interviewing skills to ensure maximum member engagement.
• Provide coaching, information, and support to empower members to make informed medical and lifestyle choices.
• Monitor and document care in compliance with regulatory and accreditation guidelines.
Requirements
• 2+ years' Case Management experience working with individuals designated as having a serious mental illness (SMI) and with elderly or physically disabled individuals.
• Strong organization, collaboration, and time management skills.
Nice-to-haves
• Computer proficiency with Outlook, Windows, and Word.
• Experience collaborating with medical professionals.
• Additional Case Management experience.
Benefits
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Numerous well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with participating partners.
• Paid Time Off (PTO) and paid holidays.
Apply Now
Apply Now
Responsibilities
• Coordinate, document, and communicate all aspects of the utilization/benefit management program.
• Conduct comprehensive evaluations of referred members' needs and eligibility.
• Recommend approaches to case resolution and meeting members' needs by evaluating their benefit plans.
• Identify high-risk factors and service needs that may impact member outcomes and care planning components.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Present cases at case conferences for multidisciplinary review to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services for members.
• Utilize influencing and motivational interviewing skills to ensure maximum member engagement.
• Provide coaching, information, and support to empower members to make informed medical and lifestyle choices.
• Monitor and document care in compliance with regulatory and accreditation guidelines.
Requirements
• 2+ years' Case Management experience working with individuals designated as having a serious mental illness (SMI) and with elderly or physically disabled individuals.
• Strong organization, collaboration, and time management skills.
Nice-to-haves
• Computer proficiency with Outlook, Windows, and Word.
• Experience collaborating with medical professionals.
• Additional Case Management experience.
Benefits
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Numerous well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with participating partners.
• Paid Time Off (PTO) and paid holidays.
Apply Now
Apply Now