• The pay for this position is $29.45 per hour.
• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance.
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.

• This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs.
• The required availability for this position is 8am to 5pm Monday-Friday

• Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare.
• Programs are comprised of utilization management, quality management, network management and clinical coverage and policies.
• Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members using care management tools and resources.
• Using care management tools and information/data review, conducts comprehensive.
• evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or
• meeting needs by evaluating member's benefit plan and available internal and external programs/services.
• Identifies elevated risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Using comprehensive approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes. Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

• Bachelors degree in social work, psychology social work or Human Services
• High School Diploma or GED
• Attendance is mandatory for the first 90 days.

• Prior case manager or case management experience

A-Line Staffing Solutions