Case Manager

healthonellc; Dalton (GA); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

401K

Health Insurance

Paid Time Off

Dental Insurance

Vision Insurance

Life Insurance

Job summary

HealthOne seeks a Case Manager to manage member care across varying risk levels, coordinating with members, providers, and benefits programs. The role requires RN licensure and CCM certification within 2 years, with strong documentation and Microsoft Office skills.

The position emphasizes adherence to HIPAA, ethical practice, and teamwork, with responsibilities spanning assessment through evaluation and ongoing care coordination. Equal opportunity employer, with comprehensive benefits.

Qualifications

• 3 years clinical experience required.
• 5 years experience in the health care industry.
• Has current Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• PC Skills required (Basic Microsoft Office and E-Mail).

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 identified through various mechanisms to ensure effective implementation of interventions and efficient utilization of benefits.
• Performs essential activities of case management including assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member's needs.
• Works closely with the utilization management department to enable workload sharing across the disciplines.
• Maintains regular and predictable attendance.
• Complies with HIPAA regulations and ethical practice.
• Promotes Company culture throughout the organization.

Skills

Clinical experience

RN licensure

Microsoft Office

Education

Certified Case Manager (CCM) credential

Job description

MISSION

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

VALUES

HealthOne is guided by a cultural framework that embodies our values and drives our decisions.

Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our PROCESS and how we get things done.

HealthOne seeks individuals with integrity and heart to embody our values. Whether you're starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

JOB PURPOSE

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

ESSENTIAL JOB DUTIES

• 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 identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
• Performs essential activities of case management including but not limited to: assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member's needs
• Various immunizations and/or associated medical tests may be required for this position
• Works closely and trains with the utilization management department to enable workload sharing across the disciplines
• Maintains regular and predictable attendance
• Consistently 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

QUALIFICATIONS

• 3 years clinical experience required
• 5 years -experience in the health care industry
• Has 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 hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law
• Preference will be given to candidates with Case Management experience

PHYSICAL REQUIREMENTS

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

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

PRE-EMPLOYMENT SCREENING

Drug Screen and Background Check Required

HEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYER

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.