Case Manager - Healthcare Provider

Case Manager - Healthcare Provider
in Boston, Massachusetts 02109 - US

Job Description

Case Manager – Healthcare Provider

There is an exciting new opportunity in our office located in Watertown for the right candidate to start right away. This full-time position has become available due to the previous case manager being promoted into a Case Lead role. You'll be joining our team of 8 which has been growing rapidly so there's plenty of potential for advancement working with high ranking company officials. This position offers unique perks and an opportunity for RN's or Case Managers to develop their career.

Responsibilities Include:
• Understands and appropriately manages member's benefits to maximize health care quality.
• Collaborates with members, families, providers, medical staff and the treatment team in order to develop, implement, authorize, and document treatment plans that include treatment goals, interventions, and expected clinical outcomes.
• Collaborates with physician reviewers, case managers, project leaders and associates to optimize member care
• Facilitates review process by communication with members, families, providers, and medical staff for information relating to benefits
• Educates and support members and families regarding benefits, eligibility, policies and processes with the goal to empower self-advocacy.
• Efficiently enter case information, check benefits and eligibility look up policy and procedures, validate provider contractual status and other functions relating to the execution of key responsibilities.
• Exhibits customer satisfaction orientation in every aspect of carrying out responsibilities.
• Completes cost avoidance and other reports and tracking tools to capture impact and/or scope of medical management responsibilities.
• Works with providers and members to ensure satisfaction of interaction
• Focuses on efficient utilization management with emphasis on discharge planning. Case management components may be required.

• 1-3 years of case management experience in medical care settings.
• RN is a huge plus!
• Excellent communication skills. Able to discuss sensitive/ confidential information in a professional, unbiased manner.
• Proven customer service skills. Works with providers and members to ensure satisfaction of interaction even though outcome may not be exactly what was desired/requested.
• Microsoft Word, Excel and Outlook.


If you're interested in joining our team, please submit a resume

For questions, please call 617-250-1000. There are no costs for candidates utilizing our services as our clients pay for all related hiring fees. All PSG job postings are either actual positions we had available at the time of posting and/or are representative of positions we typically fill or expect to fill. If you see a job that interests you, respond to the ad or give us a call so that we can help you find a job you'll love. As one of the area's largest staffing firms, we help 2,500 people find jobs a year so chances are good that we can help you too.

Professional Staffing Group is an equal opportunity employer and considers qualified applicants for employment regardless of race, gender, gender identity, gender expression, age, color, religion, disability, veteran's status, sexual orientation, or any other protected factor.


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