Case Manager

HealthOne Alliance•Dalton, GA

4d•Onsite

About The Position

The Case Manager manages member care and progress for cases with multiple levels of risk. HealthOne is guided by a cultural framework that embodies our values and drives our decisions. Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our PROCESS and how we get things done. HealthOne seeks individuals with integrity and heart to embody our values. Whether you’re starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

Requirements

3 years clinical experience required
5 years -experience in the health care industry
Has current Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire
PC Skills required (Basic Microsoft Office and E-Mail)
Registered Nurse (RN) with active license in the state of Georgia or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law

Nice To Haves

Preference will be given to candidates with Case Management experience

Responsibilities

Supports utilization management functions for more complex and non-routine cases as needed
Serves as a liaison between members, providers, and internal/external customers in coordination of health care delivery and benefits programs
Oversees highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
Performs essential activities of case management including but not limited to: assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member’s needs
Works closely and trains with the utilization management department to enable workload sharing across the disciplines
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned