Case Manager Nurse Advocate- Raleigh area

Job Summary

SYNERGY HEALTHCARE is seeking an experienced Case Manager to serve as a Nurse Advocate for new clients and their employees in the greater Raleigh area. The ideal candidate will be located in the Raleigh area and able to travel occasionally to visit clients in North Carolina and South Carolina. The role requires a thorough understanding of the healthcare system and the ability to guide and support members in navigating the complex healthcare/insurance landscape.

Key Responsibilities

• Serve as the primary point of contact for members seeking assistance with navigating the healthcare system.
• Work with members to identify their healthcare needs and provide clinical support.
• Liaison with TPAs and insurance companies to resolve claim and billing issues.
• Educate members on their healthcare benefits and how to effectively utilize them.
• Advocate for members to improve healthcare outcomes, including referrals to specialists and timely access to care.
• Collaborate with other healthcare professionals to ensure seamless coordination of care.
• Maintain accurate and up-to-date records of member interactions and healthcare interventions.
• Conduct client-facing reporting and potentially limited travel to client worksites.
• Review Health Risk Assessments to encourage lifestyle modifications and improve overall wellness.

Qualifications

• Active nursing license with a Bachelor of Science in Nursing (BSN) degree preferred.
• Minimum of 3 years of experience as a nurse case manager or in a related healthcare field.
• CCM certification or CCM eligibility, with commitment to take the CCM exam within the first year.
• In-depth knowledge of the healthcare and insurance systems.
• Strong analytical and problem-solving skills with the ability to identify and resolve complex healthcare issues.
• Excellent communication and interpersonal skills with the ability to interact effectively with employees and healthcare professionals.
• Ability to work remotely, independently, and as part of a team in a fast-paced, dynamic environment.
• Strong organizational skills with the ability to manage multiple tasks and priorities simultaneously.
• Proficiency in using electronic health records (EHRs), Outlook, Excel, and other healthcare-related software.

Benefits

This is a full-time, benefits-eligible, salaried position offering competitive pay, paid time off, and paid holidays. Synergy Healthcare also provides a flexible schedule with half-day Fridays!

Contact Information

If you are passionate about helping others and have a solid understanding of the healthcare system, we encourage you to apply for this exciting opportunity as a Case Manager Nurse Advocate with our growing organization. Please contact Dean Kiradjieff at deank@synergyhealthcare.com today!

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