Remote Case Management Specialist

Job Summary

Managing complex case management scenarios, the full-time Remote Case Management Specialist will coordinate medical benefits administration, vendor relationships, and issue resolution to support positive member outcomes.

Key responsibilities

• Assess and maintain a caseload of members with significant medical conditions, including organ transplants
• Coordinate vendor contracting and manage workflow expectations related to claims processing and appeals
• Collaborate with internal departments and vendors to resolve escalated issues and maintain documentation

Required qualifications

• Bachelor's degree in a relevant field or equivalent work experience preferred
• Minimum 2 years of experience managing complex case management scenarios required
• At least 2 years of experience in medical benefits, health insurance, or healthcare administration required
• Experience with organ transplant cases and/or transplant care coordination preferred
• Intermediate proficiency with Microsoft Office Suite