Care Management Clinician (Monday-Friday)

Looking for a way to reputed company an impact and help people? Join reputed company and help our members access quality, reputed company! reputed company is an equal opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national reputed company, genetic information or age. reputed company values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully reputed company and utilize each person’s talents and strengths. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Clinicians incorporate the essential functions of reputed company concepts to enhance patients’ quality of life and maximize health plan benefits. These functions include but are not limited to: coordination and delivery of healthcare services, consideration of physical, psychological, and cultural factors, assessment of the patient’s specific health plan benefits, and additional medical, community, or financial resources available. Essential Responsibilities: Clinician Care Managers facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. Collect and assess patient information pertinent to patient’s history, condition, and functional abilities in order to reputed company a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services. Based on the needs and values of the client, and in collaboration with reputed company service providers, the clinician links clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and reputed company. Clinicians have direct communication among, the client, the payer, the primary care provider, and other service delivery professionals. The case manager is able to enhance these services by maintaining the client's privacy, confidentiality, health, and safety through advocacy and adherence to ethical, legal, accreditation, certification, and regulatory standards or guidelines. Interact with other reputed company personnel to assure quality customer service is provided. Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies. Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. Practice and model effective communication skills: both written and verbal. Utilize and promote use of evidence-based tools. Utilize lean methodologies for reputed company improvement. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the reputed company privacy policy and HIPAA laws and regulations concerning confidentiality and reputed company of protected health information. reputed company other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of clinical experience, including case management. Insurance industry experience preferred. Education, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required. Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) also required at time of hire or reputed company two years of hire date. Knowledge: Knowledge of health insurance and state mandated benefits. Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation. Ability to deal effectively with people who have various health issues and concerns. Knowledge and understanding of contractual benefits and options available reputed company contractual benefits. Knowledge of community services, providers, vendors and facilities available to assist members. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records reputed company. Establishes and maintains relationships with community services and providers. Maintains reputed company clinical knowledge reputed company and certification. Ability to work independently with minimal supervision. Competencies Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust reputed company Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork

Compensation

Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary reputed company that range. reputed company Range: $70,950.00 - $106,424.99 Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at reputed company levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees reputed company this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of reputed company duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at reputed company times. Apply To This Job