Case Manager – Maternity

🕒 4 days ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $50k - $55k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Allied Benefit Systems

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1980

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Allied Benefit Systems is a national healthcare solutions company that provides health plan administration, care and cost management, provider network services, and data analytics to employers, members, and benefits consultants. The company focuses on reducing healthcare costs, optimizing plan performance, and improving member experience through administrative services, analytics & insights, and customizable provider networks.

📋 Description

• Help members navigate healthcare needs by coordinating care plans and connecting them with clinical resources, specialized services, and vendor partners. • Review clinical documentation, claims, and baseline case information for behavioral health, wellness, specialty prescription medications, maternity, and other health needs. • Develop strategic care plans and connect members with specialized vendor partners and Allied Care Clinicians. • Implement care plans by coordinating with members, clients, Allied staff, and vendor partners. • Collaborate with the Clinical Case Management team and other case managers to obtain clinical information. • Present cases to collaboratively identify and resolve escalated casework issues. • Communicate with CMS to obtain essential member information. • Facilitate and maintain relationships with prescription drug vendors, negotiate pricing as needed, manage member setup, and provide ongoing support. • Document casework impact, including cost savings and improvements in member health outcomes. • Perform weekly and monthly administrative tasks. • Serve as a liaison among clients, brokers, members, Allied executives, and Allied departments. • Identify and troubleshoot process issues and collaborate to optimize internal processes. • Perform other duties as assigned.

🎯 Requirements

• A bachelor’s degree or equivalent work experience is required. • Two years of experience with group health insurance and self-funded health plans required. • Excellent verbal and written communication skills. • Excellent interpersonal and customer service skills. • Excellent organizational skills and attention to detail. • Excellent time management skills, with a proven ability to meet deadlines. • Ability to review information, assess problems, and propose viable solutions. • Strong analytical and problem-solving skills. • Proficiency with Microsoft Office Suite or related software. • Experience with Medicare, Medicaid, case management, and prescription drug benefits preferred. • Experience in a clinical or social work position is a plus. • Experience working in a hospital system is a plus. • A life and health insurance producer’s license is preferred but not required.