Remote Case Manager: Chronic Conditions & Care Coordination

Paycom - ATS; Chicago, Northern (IL, KY); Hybrid; USD 50,000 - 55,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off

Tuition Reimbursement

Employee Assistance Program (EAP)

Technology Stipend

Job summary

Allied Benefit Systems is seeking a Case Manager I (Chronic Conditions) for a fully remote role. You will review clinicals and claims, design care plans, and coordinate with vendor partners to support member health outcomes.

Responsibilities include CMS communication, vendor management, and documenting case impact while collaborating with the Clinical Case Management team. A Bachelor's degree and 2 years in group health insurance are required.

Qualifications

• Bachelor’s degree or equivalent work experience required.
• 2 years of experience with Group Health Insurance and Self-Funded Health Plans.
• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills.
• Excellent organizational skills and attention to detail.
• Excellent time management skills with a proven ability to meet deadlines.
• Ability to review information, assess the problem, and propose viable solutions.
• Strong analytical and problem-solving skills.
• Medicare, Medicaid, Case Management and prescription drug benefit experience preferred.
• Experience in a clinical or social work position a plus.
• Experience working in a hospital system a plus.

Responsibilities

• Review clinicals, claims and baseline case information for health scenarios such as Behavioral, Wellness, and Specialty Prescription.
• Develop strategic care plans to support members by connecting them to vendor partners and Allied Care Clinicians.
• Coordinate care plan implementation with member, client, Allied staff and vendors.
• Collaborate with Clinical Case Management to obtain needed clinical information.
• Communicate with CMS to obtain essential member information.
• Manage prescription drug vendor relationships and pricing; support member setup.
• Document impact of casework to show cost savings and health outcomes.
• Perform weekly and monthly administrative tasks.
• Act as liaison between client/broker/member and Allied Executives.
• Troubleshoot and optimize internal processes within Enhanced Case Management.
• Other duties as assigned.

Skills

Communication

Interpersonal skills

Organization

Time management

Problem solving

Analytical thinking

Collaboration

Accountability

Initiative

Customer focus

Functional expertise

Education

Bachelor's degree or equivalent

Tools

Microsoft Office Suite

Job description

Allied Benefit Systems is seeking a Case Manager I (Chronic Conditions) for a fully remote role. You will review clinicals and claims, design care plans, and coordinate with vendor partners to support member health outcomes.

Responsibilities include CMS communication, vendor management, and documenting case impact while collaborating with the Clinical Case Management team. A Bachelor's degree and 2 years in group health insurance are required.