Case Manager, RN

🔥 8 hours ago

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Personify Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2023

⚕️ Healthcare Insurance

🧘 Wellness

🤖 Artificial Intelligence

Healthcare Insurance • Wellness • Artificial Intelligence

Personify Health is the first personalized health platform company, designed to empower individuals and organizations to achieve better health outcomes through tailored solutions and services. They offer a comprehensive range of solutions including wellbeing navigation, care management, and health plan administration, catering to employers, health systems, health plans, and brokers. Their goal is to simplify healthcare experiences and enhance engagement, ultimately helping businesses optimize their investment in employee health and wellbeing.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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