Jobs · Healthcare

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!

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