Medical Case Manager

Crawford Job Listings - GlobalLouisville, KY
77d

About The Position

The position involves providing effective case management services in a manner that is both appropriate and cost-effective. The role includes delivering medical case management services that align with URAC standards, CMSA Standards of Practice, and Broadspire Quality Assurance (QA) Guidelines. This service is directed towards patients and employees who are receiving benefits under various insurance lines, including but not limited to Workers' Compensation, Group Health, Liability, Disability, and Care Management.

Requirements

  • Experience in medical case management.
  • Knowledge of URAC standards and CMSA Standards of Practice.
  • Familiarity with Broadspire Quality Assurance (QA) Guidelines.
  • Understanding of various insurance lines including Workers' Compensation and Group Health.

Responsibilities

  • Provide medical case management services to patients/employees.
  • Ensure compliance with URAC standards and CMSA Standards of Practice.
  • Adhere to Broadspire Quality Assurance (QA) Guidelines.
  • Manage cases related to Workers' Compensation, Group Health, Liability, Disability, and Care Management.
  • Deliver services in a cost-effective manner.
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