The Care Specialist performs telephonic case management for high-risk members to assess needs, coordinate care, and monitor health outcomes. They also provide patient advocacy, educate caregivers on self-management, and collaborate with providers to ensure holistic care.
The Care Specialist performs telephonic case management for high-risk members to coordinate care and improve long-term wellness outcomes. They also educate members on self-management techniques and collaborate with interdisciplinary teams to ensure quality care and patient advocacy.
The manager provides clinical leadership and oversight for the Appeals and Grievance department to ensure regulatory compliance and timely resolution. Responsibilities include managing staff performance, handling member escalations, and identifying opportunities for workflow improvements.
The manager provides clinical leadership and ensures regulatory compliance for the appeals and grievance department. Responsibilities include managing staff performance, overseeing daily workflows, and conducting quality of care reviews.
The Case Manager performs comprehensive care management to improve member wellness through coordination of care and patient advocacy. Responsibilities include conducting telephonic assessments, managing high-risk member needs, and collaborating with interdisciplinary teams to ensure quality outcomes.
