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Healthcare Case Management Specialist
2 months ago
As a Healthcare Case Management Specialist, you will be responsible for providing comprehensive medical case management services that align with industry standards, including URAC and CMSA guidelines. This role is primarily remote, with local travel required for case management in the designated region.
Key Responsibilities- Conduct thorough reviews of case records and reports, gathering and analyzing data to assess the medical status of injured or disabled individuals.
- Identify needs and barriers to medical case resolution and return-to-work (RTW) through proactive case management strategies.
- Maintain effective communication with claims adjusters to keep them informed about case progress and secure necessary authorizations for services.
- Utilize clinical expertise to interpret medical records and diagnostic results, providing informed assessments.
- Travel approximately 70% of the time to meet with clients, healthcare providers, and other stakeholders to facilitate case resolution.
The ideal candidate will possess:
- An Associate's degree or relevant coursework/certification in Nursing.
- Active RN licensure in good standing without restrictions.
- National certification in medical case management, with the potential for advancement to Senior Medical Case Management status.
- Strong oral and written communication skills to effectively collaborate with various stakeholders.
- Basic proficiency in Microsoft Office and other relevant software.
At Crawford & Company, we are committed to fostering a culture of respect, collaboration, and inclusion. We offer:
- Competitive pay and incentive plans that recognize outstanding performance.
- Comprehensive benefit programs that support financial, physical, and mental well-being.
- Ongoing training and development opportunities to enhance your career progression.
- Initiatives that contribute positively to the communities we serve.
Join us in making a difference in the lives of those we assist, as we work together to restore lives and strengthen our community.
