Case Manager, RN

🕒 Junho 10

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Personify Health

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2023

⚕️ Seguro de Saúde

🧘 Bem-estar

🤖 Inteligência Artificial

Healthcare Insurance • Wellness • Artificial Intelligence

A Personify Health é a primeira empresa de plataforma de saúde personalizada, projetada para capacitar indivíduos e organizações a alcançar melhores resultados de saúde através de soluções e serviços sob medida. Eles oferecem uma gama abrangente de soluções, incluindo navegação de bem-estar, gerenciamento de cuidados e administração de planos de saúde, atendendo a empregadores, sistemas de saúde, planos de saúde e corretores. Seu objetivo é simplificar as experiências de saúde e aumentar o engajamento, ajudando, em última análise, as empresas a otimizar seu investimento na saúde e bem-estar dos colaboradores.

Descrição

• Provide telephonic case management between providers, patients and caregivers • Contact patient and complete a thorough assessment including physical, psychosocial, emotional, spiritual, environmental, and financial needs • Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health • Develop treatment plan for standard and catastrophic cases in collaboration with patient, caregivers or family, community resources and multi-disciplinary healthcare providers • Monitor interventions and evaluate the effectiveness of treatment plan in a timely manner • Advocate for patients by facilitating delivery of quality patient care and assisting in reducing overall costs • Maintain complete and detailed documentation of case managed patients • Evaluate and make referrals for wellness programs

🎯 Requisitos

• Knowledge of medical claims and ICD-10, CPT, HCPCS coding • Ability to critically evaluate claims data and determine treatment plan, discharge planning experience • Ability to work independently making decisions and problem solving • Knowledge of community resources and alternate funding programs • Computer proficiency or working knowledge of Microsoft Office Suite • Excellent interpersonal, communication and negotiation skills • Strong customer orientation • Good time management skills and highly organized

🏖️ Benefícios

• 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