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Manager overseeing medical review processes for Medicare claims at BlueCross BlueShield of South Carolina. Ensuring compliance with standards and laws while driving continuous improvement in claim processing.
About the role
- Part-time Care Manager Float providing care management for members with disabilities. Supporting health navigation and service coordination for clients to enhance wellness and quality of life in Wisconsin.
Responsibilities
- Join our award winning culture as we serve members in your area!
- The part-time Care Manager (CM) Float acts as a temporary member of an interdisciplinary team (IDT), serving frail elders, adults with physical disabilities and adults with intellectual/developmental disabilities who are members of Lakeland Care (LCI)
- Supports members of LCI in navigating health systems and utilizing resources to promote optimal health and wellness by providing high quality, person-centered, outcome-based care
- Coordinates and designs provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs
- Responsible for coordinating shadowing opportunities and warm hand offs as caseload transitions occur
- Monitor and evaluate the members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers
- Participate in home visits and care conferences involving the member, their supports and providers to assess and reassess long-term care needs and coordinate appropriate interventions
Requirements
- Certified Social Worker in the State of Wisconsin with a minimum of one (1) year experience working with at least one of the Family Care target populations
- A four-year bachelor’s degree or more advanced degree in Human Services or related field with one (1) year experience working with at least one of the family care populations
- A four-year bachelor’s degree or more advanced degree in any other area than Human Services with a minimum of three (3) years’ experience working with at least one of the Family Care target populations
- Ability to be adaptable, prioritize and work in a fast-paced environment
- Working knowledge of computers, computer programs, typing, and data entry
- Ability to access members’ homes which are not required to comply with the ADA regulations
- Ability to lift up to 25lbs
- Current driver’s license, acceptable driving record and proof of adequate insurance.
Benefits
- health insurance
- 401(k)
- paid time off
- flexible work arrangements
- professional development
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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