Remote Case Management Coordinator

Hornet Staffing, Inc, a GEE Group company; Columbia (SC); On-site; USD 65,000 - 90,000; Full time

Job summary

Hornet Staffing, Inc, a GEE Group company, seeks a skilled case management professional to review medical/behavioral eligibility and coordinate care for members. The role involves active case management, planning, and monitoring outcomes to ensure medical necessity and optimal services while promoting cost-effective care.

The candidate will provide telephonic support, educate members, and collaborate with providers to coordinate services, ensuring compliance with regulatory guidelines and

Qualifications

• Experience with word processing software and basic data management.
• Knowledge of quality improvement processes and related activities.
• Ability to work independently, prioritize effectively, and make sound decisions.

Responsibilities

• Review and evaluate medical or behavioral eligibility for benefits and program interventions.
• Provide active case management, assess service needs, develop action plans, and monitor services.
• Conduct telephonic support for members with chronic conditions or high-risk needs; educate and coach members.

Skills

MS Office proficiency

Analytical thinking

Communication skills

Customer service

Tools

Microsoft Office

Job description

Hornet Staffing, Inc, a GEE Group company, seeks a skilled case management professional to review medical/behavioral eligibility and coordinate care for members. The role involves active case management, planning, and monitoring outcomes to ensure medical necessity and optimal services while promoting cost-effective care.

The candidate will provide telephonic support, educate members, and collaborate with providers to coordinate services, ensuring compliance with regulatory guidelines and