Analyst, Case Management (Care Coordinator)

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver enhanced reputed company-centric 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 affordable. Position Summary 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 impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and reputed company and present with a wide range of reputed company health and social 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 social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country. 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 outcomes 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. Additional Responsibilities to include but not limited to the following: - 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 resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. • Identifies high risk factors and service needs that may impact member outcomes 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 Quality 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 outcomes. • Identifies and escalates quality of care issues through established channels. • Utilizes negotiation skills to secure appropriate options 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 actively and knowledgably participate with their provider in reputed company decision-making. - Monitoring, Evaluation and Documentation of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required Qualifications • 2 years experience in behavioral health, social services or appropriate reputed company field equivalent to program focus Preferred Qualifications • Case management and discharge planning experience preferred • Managed Care experience preferred • Bachelor's degree or non-licensed master level clinician with either degree being in behavioral health or reputed company services preferred (psychology, social work, marriage and family therapy, counseling) Education High School Diploma or equivalent GED Pay Range The typical pay range for this role is: $21.10 - $36.78 This pay range represents the reputed company hourly 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 variety 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 addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and reputed company benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-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 Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 10/11/2024 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws Apply Job!