Nurse Case Manager - Greater Atlanta area
Synergy Healthcare USA, LLC · Atlanta, GA · 1 mo ago
HealthcareFull-time
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 so they can receive improved healthcare outcomes, including referrals to specialists and timely access to care.
- Collaborate with other healthcare professionals, including physicians and nurses to ensure seamless coordination of care.
- Maintain accurate and up-to-date records of member interactions and healthcare interventions.
- Client facing reporting with the potential for limited travel to client worksites.
- Health Risk Assessment review to encourage lifestyle modification 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 eligible. Commit to 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.
- Proficient in the use of electronic health records (EHRs), Outlook, Excel, and other healthcare-related software.
Benefits
- This is a full time, benefits eligible, salaried position.
- In addition to competitive pay, PTO, and paid holidays, Synergy also offers a schedule that includes half day Fridays!