Enhanced Care Case Manager

Job Summary

Supporting the Enhanced Care Advocate and ECM team, the full-time Enhanced Care Case Manager will manage vendor, carrier, and CMS communications to evaluate cases and create strategic care plans for members with diverse health scenarios, all while working remotely.

Key responsibilities

• Review clinical, claims, and baseline case information to develop and implement care plans
• Coordinate with members, clients, and specialized vendor partners to facilitate care plan execution
• Document casework impacts to demonstrate cost savings and improved health outcomes

Required qualifications

• Bachelor's degree or equivalent work experience
• 2 years of experience with Group Health Insurance and Self-Funded Health Plans
• Experience in Medicare, Medicaid, and prescription drug benefits preferred
• Proficiency in Microsoft Office Suite or related software
• Life and Health Insurance Producers License preferred, but not required