Healthcare Case Manager

Pyramid Consulting Healthcare; Corona (CA); Remote; USD 82,656,000 - 99,187,000; Part time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k)

Paid sick leave

Job summary

Pyramid Consulting, Inc. seeks a Healthcare Case Manager for a 9–12 month contract in Corona, CA (Remote). The role focuses on managing appeals and grievances within health plans, using strong written and verbal skills.

The candidate will work standard hours with potential overtime and a first two weeks in the office. The ideal candidate has 5+ years in healthcare, proficient MS Excel/Word, and excellent customer service and communication abilities.

Qualifications

• 5+ years in healthcare, handling appeals and grievances.
• Strong written and verbal communication with clients.
• Educational background: HS diploma or GED; some college preferred.

Responsibilities

• Manage appeals and grievances for health plan members.
• Communicate with clients by phone and in writing.
• Maintain accurate records in MS Word/Excel and related systems.
• Support remote work options, with initial in-office requirement.

Skills

Customer service

Written communication

Phone communication

Microsoft Excel

Microsoft Word

Education

High School Diploma or GED

Some college

Bachelor's degree

Tools

Microsoft Excel

Microsoft Word

Job description

Immediate need for a talented Healthcare Case Manager. This is a 09-12 months contract opportunity with long-term potential and is located in Corona, CA(Remote).

Job ID:26-31274

Pay Range: $32 /hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Remote Options (Fully Remote, Partially Remote, Onsite): Telecommuter. First 2 weeks need to be in office. (might be only few day)

Key Requirements and Technology Experience:

• Min level of experience - 5 years in healthcare (handling appeals and grievances)
• Letter writes and customer service is important
• Education and Preferred Level of Education: HS Diploma but Bachelors is preferred
• How many years of related experience are you looking for in your ideal candidate? 6 years customer service.
• Heavy writing and speaking with customers over the phone. Microsoft excel, word, really help.
• M-F Normal business hours 8:30-5pm with opportunities for overtime.
• Member complaint and grievance processing preferred.
• Competent working knowledge of client Health Plan benefits plan/contracts/systems strongly preferred.
• Educational requirement - high school diploma or GED required. Some college preferred.

Our client is a leading Healthcare and Insurance Industry, and we are currently interviewing to fill this and other similar contract positions.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.