Manager

• Responsible for handling customer concerns through research and communication with involved departments/service level agreements and client products
• Collaborates with internal and external partners and staff to achieve resolution of concerns
• Manage database for cases
• Responsible for timely case resolution and maintaining compliance
• Exhibit a high level of case management expertise and demonstrated leadership skills
• Utilize care coordination to address patient and physician concerns
• Obtain insurance approval for designated therapy and proactively plan to avoid the potential of delayed coverage
• Facilitate the case management process along the healthcare continuum
• Assist with Benefit Investigations upon program need.
• Work directly with Program Supervisor to resolve escalations with the team
• Own escalations from receipt to resolution
• Collaborate with leadership on training materials and agendas.
• Identify program gaps within flows or processes and collaborate with leadership on best practices.
• Collaborate on process updates and assist through implementation.

Senior Case Manager

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