Allied Benefit Systems logo
Allied Benefit Systems

A healthcare solutions company, Allied Benefit Systems offers insurance products and custom insurance services to individuals and businesses as one of the largest third-party admin

Case Manager I

Location

United States

Posted

82 days ago

Salary

$50K - $55K / year

Seniority

Lead

No structured requirement data.

Job Description

Case Manager I

Allied Benefit Systems

Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $50,000.00 - $55,000.00 SalaryJob Category: Medical Management POSITION SUMMARY: The Case Manager I position will have a full understanding of the Enhanced Case Management (ECM) suite of strategies and supports the Enhanced Care Advocate and ECM team. The Specialist will primarily focus on vendor, carrier, and Center for Medicare and Medicaid Services (CMS), and member communication for purposes of case evaluation, appropriate referral making and determining impacts. ESSENTIAL FUNCTIONS: Review clinicals, claims and baseline case information for health scenarios such as Behavioral, Wellness, and Specialty Prescription, Maternity etc. Develop strategic, initiative care plans to support members with varying health scenarios by connecting them to specialized vendor partners and Allied Care Clinicians that can facilitate the needs of the member. Implement the care plan by coordinating with the member, client, Allied staff and/or the various specialized vendor partners. Work closely with the Clinical Case Management team and other Case Managers to obtain clinical information needed to support the care plan. This includes case presentation when needed to discuss collaboratively to identify and troubleshoot escalated issues within case work. Communicate with (CMS) to obtain essential member information. Facilitate and maintain prescription drug vendor relationships, negotiate pricing as needed, manage member set-up, and provide on-going support. Document the impact of the casework to highlight cost savings and the improvement of member health outcomes as a result of implanting a plan of care. Perform assorted weekly and monthly administrative tasks. Act as the liaison between the client/broker/member and Allied Executives and Various Departments. Troubleshoot, identify, and collaborate to optimize internal processes within Enhanced Case Management and the various Allied departments. Other duties as assigned. EDUCATION Bachelor’s degree or equivalent work experience required. EXPERIENCE AND SKILLS 2 years of experience with Group Health Insurance and Self-Funded Health Plans required. Excellent verbal and written communication skills. Excellent interpersonal and customer service skills. Excellent organizational skills and attention to detail. Excellent time management skills with a proven ability to meet deadlines. Ability to review information, assess the problem, and propose viable solutions. Strong analytical and problem-solving skills. Medicare, Medicaid, Case Management and prescription drug benefit experience preferred. Experience in a clinical or social work position a plus. Experience working in a hospital system a plus. Life and Health Insurance Producers License is preferred, but not required. Proficient with Microsoft Office Suite or related software. POSITION COMPETENCIES Job Knowledge Time Management Accountability Communication Initiative Customer Focus PHYSICAL DEMANDS Ability to sit for long periods of time. Ability to communicate via telephone. WORK ENVIRONMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.Qualifications

Related Categories

Related Job Pages

More Manager Jobs

Inception Point AI logo

Audience Development Manager

Inception Point AI

Forging AI personalities through technology and story.

Manager82 days ago
Full TimeRemoteTeam 1-10Since 2023H1B No Sponsor

• Create the dashboards, tracking systems, and analytics pipelines that measure (and drive) audience growth where no baseline currently exists. • Develop and execute growth strategies across social (Instagram), video (YouTube, TikTok), and audio (Podcasts). • Build AI agents and utilize "Clawd bots" to automate and optimize audience acquisition, distribution, and engagement beyond traditional tools. • Foster deep engagement across platforms to turn casual, passive viewers into a loyal core community. • Work with our AI personalities (e.g., Claire, Nigel, Olly) to cross-pollinate audiences and maximize individual reach across the network.

United States
$75K - $125K / year
Job Closed
bp logo

Regional Manager

bp

Delivering energy to the world, today and tomorrow.

Manager82 days ago
Full TimeRemoteTeam 10,001+Since 1909H1B Sponsor

Entity: Customers & Products Job Family Group: Retail Group Job Description: Position Summary: The Regional Manager (RM) supervises the operations of their store leadership teams across up to 13 stores. Through the demeanor of a Developer, the RM is responsible for achieving budgeted numbers, growing sales and profits, building a high-performing team of owners, leading process improvement, and championing our culture. The RM is responsible for the overall management of the daily operations of each store within the manager's territory as well as ensuring the success of the organization's objectives and objectives within each store. Essential Job Functions (Responsible to) Build a Strong, Safety Culture to Consistently Deliver Our Belief in Zero Strategy - Lead teams focused on owning personal safety every day to go home the same way they came to work. - Ensure all stores maintain Food Manager and Team Member Food Certifications, per state regulation. - Guarantee that all stores are accomplishing food safety standards, including local health department and food auditing standards. - Monitor and coach to maintain all regulatory compliance responsibilities related to restricted sales, OSHA, weights and measures and fuel compliance testing and record retention. Achieve Budgets and Grow Sales and Profit - Drive store performance to meet and exceed operating plan budgets and goals. - Supervise each store’s performance to sales, productivity, and profitability. - Lead vital adjustments using instruments and tools to achieve targeted plans and goals. - Ensure all store leaders maintain In-Stock to standards to meet guests’ needs, plan for and capitalize on regional sales opportunities, and maintain products to appropriate inventory turn and waste write off levels. - In support of the store leadership teams, develop and champion internal and external relationships to grow the business and stay current with market sales, trends, competition, and consumer data for the region. - Work closely with the Division Food Service Manager to strengthen leadership capabilities and team proficiency in food and beverage standards. Build a High Performing Team - Partner with General Managers, Talent Acquisition Advisors, and P&C support staff to recruit, select, and hire dedicated individuals aligned with our Core Values and the skill to grow with the company. - Provide consistent, direct, timely, constructive, and objective feedback. - Instill a sense of ownership and responsibility by involving team members in decision-making processes. - Hold Team Members accountable for results and enforce to company policies and procedures. - Ensure staff is in place to provide fast/friendly service to grow transactions and enhance the guest experience. - Coach, mentor, and train team staff to carry out standards and follow processes. - Provide Team Members with enough autonomy to perform their jobs optimally. - Recognize potential in Team Members for promotion and assist them in creating an appropriate time bound development plan. - Lead change and form teams skills and capabilities to stay current and relevant with our evolving business model. Lead Process Improvement - Become knowledgeable in store systems and workflows. - Apply processes, systems, and assets to ensure consistent execution of business strategy and targeted results. - Partner with store leadership to guarantee consistent store performance and brand standards. - Provide training, coaching, problem solving, and recognition to ensure that all team members understand and are able to perform to store standards within our prescribed systems and procedures. - Provide feedback to Store Support Center leadership on systems and processes to improve execution and consistency of performance in the stores, region, division, and across the company. Champion Our Culture and Recognition - Model, inspire, and coach Team Members to live store Core Values daily. - Consistently provide recognition and rewards using all available tools and resources to thank team members who live store values and strive to achieve business goals and professional/personal growth. - Care for our Team Members by always showing respect for the individual and by seeking help for those in need through programs offered. Other Considerations - Leads a safety culture through consistent demonstration of safe practices as well as standardizing safety guardrails for all field-based initiatives. - Perform other duties as assigned. - Must be in stores 80% of each work week’s schedule. - Must be willing to travel overnight 2-3 days per week on occasion. Qualifications Education - Bachelor's degree in business, communications, or equivalent work experience, preferred. Experience - Retail operations experience. - Experience in a multi-unit leadership role. - Proven results in driving sales and profitability. Skills & Competencies - Ability to create a team-oriented environment that inspires and motivates each member toward the company goals. - Ability to communicate and articulate, both written and orally, the organization's objectives to groups and individuals alike. - The capability to prepare and deliver quality presentations. - The proficiency to coach for success through consistent open and honest communication. - The competence to work on several tasks simultaneously in varying degrees of complexity and completion. - Knowledge of retail accounting and income statements. - The skills to understand and operate in a dynamic, fast-paced, 24-hour retail environment. - The ability to understand, empathize, and connect with all levels and all types of team members and guests. - Excellent digital literacy in Microsoft office suite products, including excel. How much do we pay (Base)? $100,000-$125,000 *Note that the pay range listed for this position is a genuinely expected and reasonable estimate of the range of possible base compensation at the time of posting. This position is eligible for US Benefits – Select. This position offers paid vacation depending on your years of relevant industry experience and will range from 120-240 hours of vacation per year for full time employees (60-240 hours of vacation per year for part time employees). You will also be eligible for 9 paid holidays per year and 2 personal choice holidays. You may learn more about how we calculate paid vacation and view our generous vacation and holiday schedules at Select U.S. Benefits. Bp has a parental leave policy as well, which offers up to 8 weeks’ paid leave for the birth or adoption of a child. Learn more by visiting Select U.S. Benefits. We offer a reward package to enable your work to fit with your life. These offerings include a discretionary annual bonus program, long-term incentive program, and generous retirement benefits that include a 401K matching program. These benefits include a pension for eligible employees. You may learn more about our generous benefits at Select U.S. Benefits. As part of bp’s wellbeing package, bp offers access to health, vision, and dental insurance, as well as life and Short-Term Disability and Long-Term Disability. You may learn more about our generous benefits at Select U.S. Benefits. Why join us At bp, we support our people to learn and grow in a diverse and ambitious environment. We believe that our team is strengthened by diversity. We are committed to fostering an inclusive environment in which everyone is respected and treated fairly. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform crucial job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. Travel Requirement Up to 100% travel should be expected with this role Relocation Assistance: Relocation may be negotiable for this role Remote Type: This position is fully remote Skills: Agility core practices, Agility core practices, Agreements and negotiations, Analytical Thinking, Business process improvement, Commercial Acumen, Communication, Conflict Management, Continued Learning, Continuous Improvement, Creativity and Innovation, Customer centric thinking, Customer data knowledge, Data Analysis, Data visualization and interpretation, Decision Making, Digital Collaboration, Digital Fluency, Industry knowledge and advocacy, Integrated pricing, Leading transformation, Negotiation planning and preparation, Offer and product knowledge, Offer execution and growth, Operational Excellence {+ 10 more} Legal Disclaimer: We are an equal opportunity employer. We do not discriminate on the basis of protected characteristics like race, religion, color, sex, national origin, sexual orientation, veteran status or disability status. Individuals with an accessibility need may request an adjustment/accommodation related to bp’s recruiting process (e.g., accessing the job application, completing required assessments, participating in telephone screenings or interviews, etc.). If you would like to request an adjustment/accommodation related to the recruitment process, please contact us. If you are selected for a position and depending upon your role, your employment may be contingent upon adherence to local policy. This may include pre-placement drug screening, medical review of physical fitness for the role, and background checks.

United States
$100K - $125K / year
Job Closed
Full TimeRemoteTeam 501-1,000Since 2013H1B No Sponsor

• Monitors coding & abstracting productivity and quality to ensure coding quality & performance improvement standards are maintained, achieved & improved • Establish performance guidelines in terms of quality and productivity measures • Manage and maintain a comprehensive tracking and management tool for Coding workload and prioritization • Manage Coding activities for all assigned coders and ensure that all tasks are completed in a timely manner • Ensure compliance with all applicable federal, state & local regulations • Provides guidance in the coding/abstraction, production, and quality assurance, auditing and training activities • Other duties as assigned to meet the organization’s needs

New York
$98.6K - $147.8K / year
Job Closed
Full TimeRemoteTeam 10,001+Since 1982H1B No Sponsor

• Oversee pre- and post-pay medical record reviews to support accurate coding, billing, medical necessity determinations, and coverage decisions • Manage and develop a team of Registered Nurses • Foster engagement and accountability among staff • Monitor daily inventory, capacity, and financial performance • Serve as the subject matter expert for clinical pre-pay requests • Coach the team on workflows, processes, and tools; reinforce best practices and quality standards • Track service metrics and quality results; review work regularly and take action to address trends and gaps • Set clear objectives and performance expectations for direct reports aligned to operational priorities • Provide ongoing performance coaching and career development support

United States
$93K - $155K / year
Job Closed