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Case Manager, Nutrition, Dietitian
Location
United States
Posted
63 days ago
Salary
$40 - $54 / hour
Seniority
Senior
Job Description
Case Manager, Nutrition, Dietitian
PRO-spectus
• Act as a single point of contact between the internal team, client, provider, payor, facility, and patient as needed • Support cases through approval/denial process with a sense of urgency while maintaining accuracy • Provide direction to the aligned Payor Specialist Team and coordinate efforts to ensure accuracy and completeness of each case • Identify and share trends impacting business processes with management • Prioritize and act on key client activities and follow up with customers to ensure problems are solved • Manage through ambiguity while designing innovative client and payor solutions • Make sound independent decisions in urgent and non- routine situations pertaining to client and patient scenarios • Interpret complex clinical documentation to prepare authorization documentation for payor submission in relation to medical policy criteria for coverage • Partner with the interdisciplinary team to champion their clients, patients and customers and is responsible for the life cycle of their case to ensure successful completion • Provide resources to patients, caregivers, health care providers and clients with resources available for financial assistance and transportation • Provide compassionate and empathetic support to patients and care givers with life-threatening diagnoses • Coordinate with various service providers and healthcare professionals to ensure patients receive the appropriate support before and after surgery
Job Requirements
- College Degree preferred (bachelor’s or associate degree)
- 4 – 6 years of experience in a healthcare setting and/or medical insurance background with a customer service focus
- Nutrition background with Case Management experience strongly preferred
- Experience as Clinical Dietitian a plus
- Experience with prior authorizations and appeals submissions desired
- Knowledge of reimbursement processes a plus
- Experience with maintaining detailed records of client interactions, services provided, and progress made
- Experience in developing and/or implementing new technologies a plus
- Experience with complex medical products and associated insurance processes a plus
Benefits
- robust medical, dental, and vision plans
- life insurance and disability coverage
- tax-advantaged savings accounts
- Employee Assistance Program
- home office benefits
- unique perks like an Employee Ownership Program
- paid time off
- holidays
- bereavement leave
- 401(k)-retirement plan with employer matching
- performance-based bonus opportunity
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