Company

United Claim Solutions LlcSee more

addressAddressMechanicsburg, PA
type Form of workFull-time
salary Salary$54.3K - $68.8K a year
CategoryHuman Resources

Job description

Description:

Valenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity, and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan, and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality, and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare.

About Our Opportunity

As a Case Management Supervisor within our KISx Team, you oversee the work of a team of Case Managers to ensure that members receive high-quality care and are effectively managed throughout the continuum of care. You’ll also manage and work a reduced caseload.

Things You’ll Do Here:

Supervision

  • Supervise a team of Case Managers providing guidance, support, and training as needed.
  • Work with leadership to develop and implement Case Management policies, procedures, and guidelines that promote the delivery of high-quality, patient-centered care.
  • Ensure compliance with eligibility verification requirements, and first dollar IRS/HSA laws.
  • Collaborate with healthcare providers and clients to promote effective and efficient care coordination and communication across the healthcare continuum.
  • Participate in quality improvement initiatives and committees to promote continuous quality improvement.
  • Provide education and training to the internal team during the onboarding process and when the need for education and support arises.
  • Ensure timely and accurate communication with healthcare providers and payers regarding Case Management decisions.

Case Management

  • Evaluate care management plan goals regularly and modify as necessary.
  • Update processes and changes within SharePoint, as needed.
  • Assist with medical records review for appropriateness for program utilization.
  • Educate and assist patients in understanding their condition, improve self-management, and refer them to appropriate resources.
  • Assist with identifying areas of improvement in processes and operations.
  • Oversee daily operations to ensure effective care and communication are provided to members.
  • Provide float coverage for staffing as needed.
  • Collaborate with other departments to promote coordination and communication within the Company regarding administrative activities, quality improvement, and clinical operations.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

Where You’ll Work

This is an in-office role! Our office is located at 1 Kacey Ct, Ste 100 in Mechanicsburg, PA.

Why You Will Love Working Here

We offer employee perks that go beyond standard benefits and compensation packages – see below!

At Valenz, our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. We want everyone engaged within our ecosystem to be strong, vigorous, and healthy. You’ll find limitless growth opportunities as we grow together. If you're ready to utilize your skills and passion to make a significant impact in the healthcare self-funded space, Valenz might be the perfect place for you!

Perks and Benefits

  • Generously subsidized company-sponsored Medical, Dental, and Vision insurance.
  • Spending account options: HSA, FSA, and DCFSA
  • 401K with company match and immediate vesting.
  • Flexible working environment.
  • Generous Paid Time Off to include Vacation, Sick, and Paid Holidays.
  • Paid maternity and paternity leave.
  • Community giveback opportunities, including paid time off for philanthropic endeavors.

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

Requirements:

What You’ll Bring to the Team:

  • 2+ years of experience in Case Management.
  • 2+ years of experience supervising or leading a team of case managers.
  • Current RN license in residing state.
  • Strong aptitude for relationship building with a highly effective communication style.
  • Ability to work in a fast-paced, detailed, deadline-driven environment.

A plus if you have:

  • Health insurance experience
  • Experience with hourly billing for CM services

Benefits

Paid parental leave, Health savings account, Health insurance, Dental insurance, Flexible spending account, Paid time off, Parental leave, Vision insurance, 401(k) matching
Refer code: 8533409. United Claim Solutions Llc - The previous day - 2024-03-11 04:26

United Claim Solutions Llc

Mechanicsburg, PA
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