Case Management Social Services Coordinator I

🔥 15 hours ago

🇺🇸 United States – Remote

💵 $26 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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Personify Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2023

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

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

• Manage short- and long-term cases by phone and virtually • Conduct biopsychosocial assessments covering physical, emotional, psychosocial, spiritual, environmental, and financial needs • Use claims-processing tools to analyze paid claims, identify risk indicators, and determine program eligibility • Develop individualized care plans with measurable short- and long-term goals • Monitor interventions, evaluate effectiveness, and document outcomes • Coordinate resources, support care transitions, and refer members to wellness, behavioral health, and community-based services • Maintain contact with members, caregivers, providers, employers, and the interdisciplinary team • Implement and document cost-management strategies, including monthly case reviews and cost-avoidance data • Maintain accurate records in required systems and prepare 30-day interval updates • Maintain site-specific files in line with HIPAA and confidentiality rules • Meet URAC and NCQA requirements, complete annual trainings, and meet productivity, quality, and turnaround standards • Support department operations and implementations • Participate in team meetings and case discussions • Contribute ideas for process improvement

🎯 Requirements

• Bachelor’s or Master’s degree from an accredited Social Work program • Minimum 2 years of acute healthcare experience • Experience with psychosocial assessment, care planning, and service navigation for vulnerable or high-risk populations • Working knowledge of URAC and NCQA standards and HIPAA confidentiality requirements • Knowledge of medical claims and ICD-10, CPT, and HCPCS coding • Foundational clinical judgment, social work principles, and motivational interviewing • Proficiency in Microsoft Word, Excel, and Outlook • Basic computer literacy, proficient typing, and ability to work across multiple screens • Proficiency in Teams, SharePoint, shared drives, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Smartsheet, and a phone system with headset • Full system proficiency expected after training and a 1.5-month ramp (3 months total)

🏖️ Benefits

• Competitive base salary and benefits effective day one • Comprehensive medical and dental through our own health solutions • Paid Time Off • Mental health support • Retirement planning • Financial protection • Professional development with clear career progression and learning budgets • Mission-driven culture where diverse perspectives drive real impact • Wellness programs • Other employee perks • Full benefits package starting day one

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