Case Management Coordinator

Personify Health

2d • $18 - $23 • Remote

About The Position

Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives.
Learn even more about the work that drives us at personifyhealth.com.

Requirements

• Basic computer literacy
• The ability to work on multiple screens, and proficient typing skills.
• Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook Excellent verbal and written communication skills
• Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
• Ability to work independently and utilize written resources to problem solve.
• Teams on and off camera, SharePoint, Drives as needed, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Phone system with headset, Smartsheet—there may be additional programs as it relates to particular job duties
• Knowledge of medical claims and ICD-10, CPT, HCPCS coding
• Excellent verbal and written communication skills for upward and downward conversations
• Coordination of care experience in an insurance or hospital setting
• 1+ year clinical experience required.
• Ability to perform the essential job functions safely and successfully with or without reasonable accommodation, including meeting qualitative and/or quantitative productivity standards.
• Ability to keep regular, punctual attendance.
• Ability to sit for 6-8 hours.
• Constant use of computer keyboard and mouse; repetitive use of both hands.
• Occasional to frequent twisting of neck; occasional bending of neck and at waist.

Responsibilities

• As a Disease Management Case Management Coordinator you will proactively contact targeted members to engage them in chronic disease management programs.
• Provide exceptional customer service during all telephonic interactions.
• Establish and maintain working relationships with internal departments, healthcare providers, client/groups, and patients.
• Assist members in establishing a primary care provider and or locating an in-network primary care provider.
• Evaluate member needs and make referrals to case management, prenatal programs, or pharmacology reviews as appropriate
• Ability to meet productivity, quality, and turnaround times on daily, weekly, and monthly requirements.
• Ability to pass external audits to include URAC and NCQA.
• Maintain HIPPA compliance per company’s policy and procedures.
• Maintain confidentiality and minimum requirement rules.
• Complete all required yearly training per company’s expected period.

Benefits

• Competitive base salary and benefits effective day one
• Comprehensive medical and dental through our own health solutions (yes, we use what we build)
• Paid Time Off—rest and recharge time is non-negotiable
• Mental health support, retirement planning, and financial protection
• Professional development with clear career progression and learning budgets
• Mission-driven culture where diverse perspectives drive real impact on people's health

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed