Senior Case Manager

🕒 il y a 7 jours

🇺🇸 États-Unis – Télétravail

💵 $100 000 - $130 000 / an

⏰ Temps Plein

🟠 Senior

👔 Manager

🦅 Parrain de Visa H1B

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Arlo

Site WebLinkedInTous les Emplois

11 - 50 employés

Fondée en 2022

⚕️ Assurance santé

🤝 B2B

👥 RH Tech

💰 €4 000 000 Seed Round - Arlo en 2025-03

Healthcare Insurance • B2B • HR Tech

Arlo est une plateforme autonome de plan de santé et de prestations pour les petites et moyennes entreprises, offrant une assurance santé transparente axée sur la prévention avec des prix prévisibles, des soins primaires gratuits et des soins urgents virtuels, un support concierge et une application mobile pour simplifier l'administration pour les employeurs et les courtiers. Elle offre une couverture nationale dans la plupart des États (à l'exception de WA, NY, HI, DC, et OK), est adaptée pour des équipes d'environ 10 à 150 employés, et met l'accent sur des tarifs transparents à l'avance, une réduction des refus de réclamations et une stabilité des taux d'une année sur l'autre.

Description

• Review claims, prior auth requests, and ADT (admission/discharge/transfer) data to identify members who would benefit from case management • Conduct clinical assessments and build individualized care plans with members • Coordinate directly with PCPs, specialists, hospitals, and post-acute providers to ensure care plans are executed and gaps are closed • Support members through complex episodes — new diagnoses, hospitalizations, transitions of care, and chronic condition management • Partner with our utilization management workflows on medical necessity questions and appropriate level of care • Help us build the playbook: contribute to protocols, escalation pathways, and the tooling we use to do this work well • Document thoroughly and maintain compliance with applicable regulatory and accreditation standards

🎯 Exigences

• Active, unrestricted RN license; multi-state compact license strongly preferred • 5+ years of clinical nursing experience, with relevant experience in case management, utilization management, care coordination, or discharge planning • Comfort reading and interpreting claims data, prior auth criteria (MCG/InterQual), and clinical documentation • Strong communication skills — you can hold your own with a skeptical specialist and also meet a member where they are • Self-directed; you can run your panel without someone over your shoulder • Comfort working in a fast-moving environment where processes are still being built

🏖️ Avantages

• High ownership: You’ll get real responsibility from day one—our high-trust team empowers you to run with big problems and shape core parts of the company. • Join an important mission: Your work directly influences how people access care and improves lives at scale. • Growth & expansion: We’re moving fast, and as we grow, your scope will grow with us—new challenges, bigger opportunities, and rapid career velocity. • Apply AI to a problem that matters: Instead of optimizing ads or cutting labor costs, you’ll use AI to fundamentally reimagine how people get healthcare. • High pace, high collaboration: We operate with velocity, first-principles thinking, and a team that works closely, openly, and with ambition.