Case Manager Nurse Advocate- Raleigh area

Synergy Healthcare USA, LLC; North Carolina; On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Paid time off (PTO)

Paid holidays

Half day Fridays

Job summary

Synergy Healthcare USA, LLC is seeking a Case Manager Nurse Advocate for the Greater Raleigh Area. This full-time position allows for remote work with minimal travel within NC/SC for client visits. Responsibilities include helping members navigate their healthcare options, advocating for improved outcomes, and working with insurance companies. Candidates should possess an active nursing license, a BSN (preferred), and 3+ years of relevant experience. Benefits include competitive pay and a flexible schedule with half-day Fridays.

Qualifications

• Active nursing license and BSN preferred.
• Minimum of 3 years of experience as a nurse case manager or similar.
• CCM certification or commitment to obtain within the first year.

Responsibilities

• Serve as primary contact for members navigating healthcare.
• Work with members to identify healthcare needs.
• Liaise with TPAs to resolve claim and billing issues.
• Educate members on their healthcare benefits.

Skills

Active nursing license

Analytical and problem-solving skills

Excellent communication skills

Organizational skills

Ability to work remotely

Education

Bachelor of Science in Nursing (BSN)

Tools

Electronic health records (EHRs)

Outlook

Excel

Job description

SYNERGY HEALTHCARE: Case Manager Nurse Advocate – Greater Raleigh Area

Job Summary

We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new clients and their employees. The ideal candidate will be located in the greater Raleigh area, with the ability to travel on occasion to visit clients in NC/SC. He/she must have a thorough understanding of the healthcare system, and will be responsible for providing guidance and support to members in navigating the complex healthcare/insurance landscape.

As a dedicated Nurse Advocate, you will be responsible for resolving a myriad of issues for their members and allowing you the flexibility to “think outside the box”. With your clinical experience and background, you will help members better understand their health status and available treatment options. You will have a unique opportunity and have time to develop valued relationships with members and executive teams with your specific employer clients.

This opportunity allows for remote work so can be flexible on location. Minimal travel within the States of NC/SC for periodic client visits (open enrollment meeting, annual activity reviews etc) may be required. Most if not all work will be done virtually out of the convenience of your own home office.

The key to your success will rely on your ability to cultivate trusted relationships with stakeholders, members, and their families. Our growing Synergy team is passionate about delivering an exceptional healthcare experience that is personal, data driven, and value based to help every person live their healthiest life.

Key Responsibilities

• Serve as the primary point of contact for members seeking assistance with navigating the healthcare system.
• Work with members to identify their healthcare needs and provide clinical support.
• Liaison with TPAs and insurance companies to resolve claim and billing issues.
• Educate members on their healthcare benefits and how to effectively utilize them.
• Advocate for members so they can receive improved healthcare outcomes, including referrals to specialists and timely access to care.
• Collaborate with other healthcare professionals, including physicians and nurses to ensure seamless coordination of care.
• Monitor member health status and progress towards achieving their healthcare goals.
• Maintain accurate and up-to-date records of member interactions and healthcare interventions.
• Client facing reporting with the potential for limited travel to client worksites.
• Health Risk Assessment review to encourage lifestyle modification and improve overall wellness.

Qualifications

• Active nursing license with a Bachelor of Science in Nursing (BSN) degree preferred.
• Minimum of 3 years of experience as a nurse case manager or in a related healthcare field.
• CCM certification or CCM eligible. Commit to CCM exam within the first year.
• In-depth knowledge of the healthcare and insurance systems.
• Strong analytical and problem-solving skills with the ability to identify and resolve complex healthcare issues.
• Excellent communication and interpersonal skills with the ability to interact effectively with employees and healthcare professionals.
• Ability to work remotely, independently, and as part of a team in a fast-paced, dynamic environment.
• Strong organizational skills with the ability to manage multiple tasks and priorities simultaneously.
• Proficient in the use of electronic health records (EHRs), Outlook, Excel, and other healthcare-related software.

Benefits

This is a full time, benefits eligible, salaried position. In addition to competitive pay, PTO, and paid holidays, Synergy also offers a schedule that includes half day Fridays!

If you are passionate about helping others and have a solid understanding of the healthcare system, we encourage you to apply for this exciting opportunity as a Case Manager Nurse Advocate with our growing organization. Please contact Dean Kiradjieff at [e-mail] today!