Specialized Services Clinical Administrator

Put your talents to work at PCM! Whether you work in our Home Care, Clinical Research, Impairments, or Catastrophic Care division, you will support our mission to deliver care and other services that enhance the quality of life of our clients. Be a part of our dynamic client-focused team and make a difference in your career!

QUALIFICATIONS:

• Registered Nurse
• Knowledge of the EEOICPA program and key stakeholders’ operating practices (e.g. DOL Resource Centers) is strongly preferred -. Demonstrates strong verbal, written and interpersonal communication skills.
• Strong computer skills.
• Speaks, reads, writes, and comprehends English. Written communication is particularly important in this role.
• Demonstrates time management, organizational skills, and ability to function with minimal direction.
• Experience with letter writing on behalf of claimants in the EEOICPA Program is highly desirable.
• Diligently maintains claimant contact records in Salesforce
• Extensive knowledge of conditions that are common to White Card holders/EEOICPA claimants.
• Offers subject matter expertise and creativity in helping claimants whose circumstances lie outside of established processes
• Utilize strong phone skills – this role requires extensive time on the phone, but is not considered a Call Center position
• Provide exceptional customer service to claimants
• Build strong relationships with team members, physicians, and Case Managers.

ESSENTIAL FUNCTIONS/AREAS OF ACCOUNTABILITY

• Liaising with PCM’s Clinical Operations and Home Care clients regarding prospective new conditions that can potentially be added to a client’s white card
• Write clinical summaries to assist the Specialized Services physician
• Educate Home Care clients on the benefits to them of adding new covered conditions
• Document all steps in Salesforce and update as applicable
• Work directly with clients and Case Managers to guide them through the DOL process
• Request records from treating physicians and providers in support of the claim
• Follow up with claimants at each step of their DOL authorization process to gauge progress and offer additional guidance
• Answer claimant questions regarding the DOL - processes and EEOICPA program and benefits

Individual base pay depends on various factors, in addition to primary work location, complexity and responsibility of role, job duties/requirements, and relevant experience, skills and other market-based factors.

Available Benefits Include

• Medical
• Dental
• Vision
• 401(k)
• Company Paid Short Term Disability
• Flexible Spending Account (FSA)
• Health Savings Account (HSA)
• Paid Time Off
• Voluntary Benefits

Professional Case Management is an Equal Opportunity Employer.