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Case Manager, Nutrition, Dietitian

Location

United States

Posted

63 days ago

Salary

$40 - $54 / hour

Seniority

Senior

Bachelor Degree5 yrs expEnglish

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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