Case Manager I

Job Summary

A company is looking for a Case Manager I to support the Enhanced Care Advocate and ECM team in managing member health scenarios.

Key Responsibilities

• Review clinicals and claims to develop and implement strategic care plans for members
• Coordinate with members, clients, and vendor partners to facilitate care plans
• Document casework impacts and maintain relationships with prescription drug vendors

Required Qualifications

• Bachelor's degree or equivalent work experience required
• 2 years of experience with Group Health Insurance and Self-Funded Health Plans required
• Medicare, Medicaid, Case Management, and prescription drug benefit experience preferred
• Experience in a clinical or social work position is a plus
• Life and Health Insurance Producers License is preferred, but not required