Case Management Coordinator

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

The Case Management Coordinator is a work-from-home position with travel required in Maricopa County, Arizona, to visit members. This person coordinates, documents, and communicates all aspects of the utilization/benefit management program, applying critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity criteria for members.

Job Duties:

• Evaluate members' needs and eligibility, recommending approaches to case resolution and meeting needs by assessing benefit plans and available programs/services.
• Identify high-risk factors and service needs impacting member outcomes and care planning, making appropriate referrals.
• Coordinate and implement care plan activities, monitoring progress.
• Enhance medical appropriateness and quality of care using a holistic approach, presenting cases at case conferences for multidisciplinary review.
• Identify and escalate quality of care issues, utilizing negotiation skills to secure suitable options and services.
• Provide coaching, information, and support to empower members to make independent medical and healthy lifestyle choices.

Required Qualifications:

• 2+ years of experience in case management, working with people with serious mental illness, elderly individuals, and members with physical disabilities.
• Reside in Maricopa County, Arizona.
• Willingness to travel up to 50% of the time within Maricopa County, Arizona.

Preferred Qualifications:

• Strong organizational and time management skills.
• Ability to collaborate with internal and external partners.
• Proficiency in Microsoft Office Suite, including Outlook and Word.
• Previous experience collaborating with medical professionals.
• Bilingual (English/Spanish).

Education:

• Bachelor's degree in Social Work, Psychology, Special Education, or Counseling, or a licensed RN (Registered Nurse) valid in Arizona.

Anticipated Weekly Hours: 40

Time Type: Full-time

Pay Range: $21.10 - $40.90

Benefits:

This full-time position is eligible for a comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.