Case Manager I

2 hours, 12 minutes ago
Full-time
Junior
Customer and Technical Support
Healthcare Management Administrators

Healthcare Management Administrators

Healthcare Management Administrators is a specialized third-party administrator that provides high-quality, innovative, and affordable health plans for self-funded employers, emphasizing exceptional service and a collaborative partnership model.

Insurance
251-1K
Founded 1986

Description

  • Provide holistic primary care management for assigned client groups across medical and managed behavioral health services.
  • Monitor member utilization and claim patterns and manage complex care cases over time.
  • Collaborate with brokers, group contacts, and stop loss partners while maintaining HIPAA compliance.
  • Assess, plan, implement, coordinate, monitor, and evaluate proposed treatment plans.
  • Review treatment progress and provide personalized support and care coordination for complex, catastrophic, or chronic conditions.
  • Evaluate requested services to determine whether they meet individual health care needs and support continuity of care.
  • Perform utilization management using the terms of the Summary Plan Description, including benefit limitations, exclusions, and provider or facility PPO status.
  • Review appropriateness of services, care setting, level of care, and length of stay using approved criteria.

Requirements

  • Baccalaureate degree in Nursing or Community/Public Health preferred.
  • 1-3+ years of clinical nursing experience.
  • Active RN clinical license or certification, as applicable to the degree.
  • Strong clinical practice experience with diverse diagnoses.
  • Knowledge of case management and utilization review processes.
  • Excellent client-facing verbal and written communication skills.
  • Developing leadership skills and strong problem-solving and critical thinking abilities.
  • Ability to be self-motivated, self-directed, and effective in a deadline-oriented environment.
  • Behavioral health experience preferred.
  • Proficiency with Microsoft Office applications, including Outlook, Word, and DOSS.

Benefits

  • Base salary of $85,000-$99,000 in the greater Seattle area, depending on geography, skills, experience, education, and other factors.
  • Performance-based incentive bonus opportunities.
  • 17 paid time off days for individual contributors, plus 11 paid holidays.
  • Two paid personal days and one paid volunteer day.
  • Company-subsidized medical, dental, vision, and prescription insurance.
  • Company-paid disability, life, and AD&D insurance, plus voluntary insurance options.
  • 401(k) retirement plan with company match and HSA/FSA pre-tax programs.
  • Annual $500 wellness incentive, $600 wellness reimbursement, remote work options, continuing education reimbursements, discount program, parental leave, and up to $1,000 annual charitable giving match.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

CRM Coordinator

Virtual Assistance Services 11-50 Professional Services

A premium Australian medispa business is hiring a part-time remote CRM Coordinator to manage client communications, booking follow-up, and database activities that convert marketing interest into clinic appointments.

1 hour, 27 minutes ago

Customer Success Engineer - Austin, TX

VulnCheck 11-50 Internet Software & Services

VulnCheck is hiring a remote Customer Success Engineer in the Greater Austin, TX area to help enterprise and security customers implement, integrate, and operationalize its vulnerability intelligence platform across their workflows.

Cybersecurity Go JSON Python REST API SIEM
1 hour, 42 minutes ago

Bilingual Enrollment Coordinator - CMA/RMA in MST or PST

Classet 1-10 Internet Software & Services

Chronic Care Staffing is hiring a remote CCM/RPM Enrollment Coordinator to support chronic care programs by guiding patients through enrollment and helping coordinate care from a remote setting.

HIPAA
1 hour, 57 minutes ago

Customer Success Operations Coordinator, APAC

Revinate 51-250 IT Services

Revinate is hiring a Customer Success Operations Coordinator in India to support its APAC Customer Success team by managing account operations, onboarding Guest Feedback customers, and handling frontline support for global hospitality accounts.

JIRA Salesforce
1 hour, 57 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers