Current jobs related to Case Manger - Pittsburgh - WeCare Centers

Job DescriptionJob DescriptionDescriptionCome join the team with WeCare

This is a remote position

Under the guidance and supervision of the Director of Care Transition, the Case Manager will play a critical role in managing and facilitating care transitions by overseeing the coordination and authorization of patient care services. This position ensures that care is delivered efficiently and in line with insurance policies while optimizing patient outcomes. The Case Manager will work closely with healthcare providers, facility staff, and insurance reviewers to ensure smooth, timely, and appropriate care delivery.
Key Responsibilities- Provide support for utilization management tasks, particularly for complex or atypical cases, ensuring the effective use of healthcare services.- Serve as a liaison between facility staff, healthcare providers, and insurance companies to expedite insurance authorizations and facilitate communication.- Manage highly complex cases identified through various channels, ensuring appropriate interventions, maximizing the use of available benefits, and improving patient outcomes.- Perform key case management functions, including assessment, care planning, implementation of care plans, coordination of services, monitoring patient progress, and evaluating outcomes.- Conduct reviews of patient cases to ensure they meet criteria for continued care and insurance coverage.- Handle all communication related to patient care authorization and ensure all necessary documentation is submitted to insurance companies in a timely manner.- demonstrate proficiency in navigating and communicating through digital platforms. Provide basic technical support, as needed, while adhering to high standards for typing accuracy and grammar.- Successfully complete required standard Windows Testing to ensure proficiency in the use of technology for the role.
Skills, Knowledge and Expertise - Experience in case management and utilization review, particularly in a healthcare setting.- Strong understanding of insurance authorization processes and requirements- Ability to manage complex cases and work in a fast-paced environment while maintaining attention to detail.- Strong communication and collaboration skills for interacting with providers, staff, and insurance reviewers.- Proficiency in using digital platforms for communication and record-keeping.- Excellent organizational, problem-solving, and critical thinking skills. 

BenefitsHealth Insurance 

Dental Insurance 

Vision Insurance 

Voluntary Benefits 

Same Day Pay

401k with discretionary match

EAP 

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