Description
Logistics
This position is full time (40 hours/week) Monday-Friday 8:00-4:30 and will be Flexible 50% onsite and 50% work from home in Juno Beach Florida. To work from home you must have high-speed (non-satellite) internet and a private home office.
What You Will Do:
Provides active case management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals. Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, hi...