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Job Summary:
- Provide telephonic case management between providers, patients, and caregivers for cost-effective, high-quality healthcare.
- Work may include evening and/or weekend shifts.
Essential Functions:
- Contact patients for thorough assessments including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
- Review claims data, develop treatment plans, and monitor interventions for effectiveness.
- Advocate for patients and negotiate cost management strategies to achieve quality outcomes.
Qualifications:
- Knowledge of medical claims and ICD-10, CPT, HCPCS coding.
- Ability to work independently, problem solve, and critically evaluate claims data.
- Strong interpersonal, communication, and negotiation skills with excellent time management.
Personify Health
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers and health plans with data-driven solutions and are on a mission to empower people to lead healthier lives.