Case Manager

Job Summary

Providing day-to-day case management oversight, the full-time remote Case Manager will coordinate an assigned caseload, ensuring timely completion of tasks, managing prior authorizations, and serving as a primary resource for patients and healthcare providers.

Key responsibilities

• Oversee and coordinate caseload to ensure timely completion of all case elements and tasks
• Act as the single point of contact for prior authorization and appeal processing communications with stakeholders
• Assess patient eligibility for additional services and perform quality checks on cases, reporting trends to leadership

Required qualifications

• Bachelor's degree or six years of relevant working experience
• Two or more years of relevant experience in pharmacy benefit management preferred
• Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred
• Proficiency in Microsoft Office applications
• Knowledge of medical and claims processing terminology