Case Manager

The Case Manager manages member care and progress for cases with multiple levels of risk.

Responsibilities

Supports utilization management functions for more complex and non-routine cases as needed; Serves as a liaison between members, providers, and internal/external customers in coordination of health care delivery and benefits programs; Oversees highly complex cases to ensure effective implementation of interventions and efficient utilization of benefits; Performs essential case management activities including assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member's needs; Works closely and trains with the utilization management department to enable workload sharing across disciplines; Maintains regular and predictable attendance; Demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice; Works to encourage and promote Company culture throughout the organization; Other duties as may be assigned

Requirements

3 years clinical experience required; 5 years experience in the health care industry; Current Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire; PC skills required (basic Microsoft Office and E-Mail); Registered Nurse (RN) with active license in the state of Georgia, or a license in the state of residence if that state participates in the Nurse Licensure Compact Law; Drug screen and background check required; Various immunizations and/or associated medical tests may be required; Prolonged periods of sitting at a desk and working on a computer; Moderate to significant stress in meeting deadlines; Must be able to drive a vehicle and travel daytime/overnight as required

Nice to have

Case Management experience

Benefits

401K (4% Match, Immediate Vesting); Accident insurance; Competitive salary; Critical Illness Insurance; Dental Insurance; Employee Assistance Program; Flexible Spending Account; Health & Wellness Program; Health Savings Account; Life & AD&D Insurance; Long Term Disability; Medical Insurance; Paid Time Off; Pet Insurance; Short Term Disability; Vision Insurance