Pharmacy Enhanced Case Management Coordinator III

Allied Benefit Systems, Inc.; Illinois; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking an ECM Coordinator to provide essential administrative support within the medical management field. This role requires engaging with members to offer resources related to their medical conditions, managing case work, and collaborating with internal and external stakeholders. The ideal candidate will have a strong background in administrative support, excellent communication skills, and a passion for patient care. Join a forward-thinking organization that values its employees and offers a competitive benefits package, including medical, dental, and generous paid time off. This is an exciting opportunity to make a meaningful impact in healthcare.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Generous Paid Time Off

Tuition Reimbursement

Employee Assistance Program

Technology Stipend

Qualifications

• 3-5 years of administrative support experience required.
• Understanding of medical terminology and benefit plan design.

Responsibilities

• Support department staff with administrative tasks related to medical conditions.
• Document engagements accurately in the CRM system.
• Manage escalated case management questions from members.

Skills

Administrative Support

Patient-Provider Engagement

Needs Assessments

Coordination of Care

Analytical Skills

Problem-Solving Skills

Verbal Communication

Written Communication

Education

Bachelor's Degree

Tools

Microsoft CRM

Job description

Job Details

Job Location: Allied Benefit Systems - CHICAGO, IL

Position Type: Full Time

Salary Range: $21.00 - $23.00 Hourly

Job Category: Medical Management

Description

POSITION SUMMARY

An ECM Coordinator supports department staff with administrative tasks related to a member’s medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care.

ESSENTIAL FUNCTIONS

1. Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products.
2. Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system.
3. Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders.
4. Collaborate with strategic vendor partners to provide supportive services and support to members.
5. Lead and facilitate claims auditing in conjunction with ECM Coordinators.
6. Complete department auditing related to daily tasks to ensure accuracy and identify escalations.
7. Identify impactful scenarios through appropriate closing summaries in timely fashion.
8. Share impactful scenarios with the department’s leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership.
9. Identifying escalations for department leadership team, as appropriate.
10. Other duties as assigned.

EDUCATION

1. Bachelor’s Degree or equivalent work experience, required.

EXPERIENCE AND SKILLS

1. At least 3-5 years of administrative support experience required.
2. Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred.
3. Experience in pharmacy claims or specialty drugs preferred.
4. Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes.
5. Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc.
6. Strong verbal and written communication skills.
7. Strong analytical and problem-solving skills.

COMPETENCIES

1. Communication
2. Customer Focus
3. Accountability
4. Functional/Technical Job Skills

PHYSICAL DEMANDS

1. This is a standard desk role – long periods of sitting and working on a computer are required.

WORK ENVIRONMENT

1. Remote

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.

Qualifications