A direct hire opportunity is available for a Case Manager / LPN Care Coordinator in Miami, FL. This role is ideal for an experienced Licensed Practical Nurse who wants to use clinical knowledge in a non-bedside, insurance-focused care coordination setting.
The Case Manager will support insured student members by helping them navigate healthcare services, insurance benefits, claims, referrals, authorizations, and provider access.
Responsibilities
- Conduct outreach calls to insured members to complete basic health assessments, review care needs, and follow up on active cases.
- Coordinate healthcare services for students, including locating appropriate in-network providers, facilities, specialists, DME, and home health resources when needed.
- Review medical records, utilization history, claims activity, benefits, referrals, and prior authorizations to support accurate case management.
- Assist with claims follow-up, eligibility verification, benefit questions, provider network research, and insurance navigation.
- Maintain accurate case notes while ensuring HIPAA compliance and confidentiality of all medical information.
Qualifications
3+ years of experience in health insurance, HMO setting.
Strong medical background with knowledge of medical terminology, clinical workflows, and basic chronic disease management.
Familiarity with commercial HMO/managed care, including claims, referrals, prior authorizations, and benefits.
...Meat Department SupervisorTo provide quality customer service by directing and supervising all functions and activities of Meat Department... ....Follows approved Meat department plans for effective space management based on product movement, consumer demand, and on...
...Job Title: Tax Preparer Department/Business Unit: Managed Operations Reports to: Office Supervisor Status: Seasonal FLSA Status: Non-Exempt Job Summary Tax Preparer role involves preparing accurate tax returns for individuals and small...
...Driver Helper OpportunityWaste Connections is seeking a motivated Driver Helper to join our growing team in Acworth, Georgia. This is an excellent... ...an experienced CDL Driver, learn the business from the ground up, and have the opportunity to obtain your Class A or Class B CDL...
...Driver HelperUnder close supervision, this position is responsible for loading, delivering, and unloading products using various equipment... ...nights and/or weekends if neededAbility to lift product, up to 50 lbs with or without reasonable accommodationAbility to move...
...UX Writer Telecommunication is seeking a UX Writer to join its API Program and lead writing efforts for business-critical APIs and other developer tools on internal and external websites. The UX Writer will work within the API Program product team to help shape the...