Case Manager

Responsibilities:

• Conduct telephone interviews and gather information from claimants, providers, and clients
• Perform three-point contact and direct care into the network
• Follow up on treatment status and correspond with providers
• Evaluate and coordinate treatment plans proposed by providers
• Authorize medical treatment and diagnostic testing on assigned claims
• Act as a liaison with clients to address issues related to medical care and treatment plans
• Initiate calls and correspondence to coordinate courses of treatment
• Identify claims involving complex injuries/treatment plans and refer them to a nurse case manager

Education Qualification:

• Bachelor's degree preferred
• Minimum of two years of business experience, preferably in a medical support related position or health insurance environment

Required Skills:

• Familiarity with intranet and internet applications
• Understanding of medical terminology
• Knowledge of case management philosophy and process preferred
• Strong typing, data entry, and numeric keypad skills
• Comfortable using a calculator for simple math calculations
• Analytical and problem-solving skills
• Customer focus and interpersonal skills
• Effective communication (verbal and written) and organizational skills
• Decision-making abilities
• Flexibility and adaptability

• RN
• Registered nurse
• Case manager