| Location | Dalton, Georgia |
ESSENTIAL JOB DUTIES Supports utilization management functions for more complex and non-routine cases as needed Serves as a liaison between members, providers, and internal/external customers in coordination of health care delivery and benefits programs Oversees highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits Performs essential activities of case management including but not limited to: assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member’s needs Various immunizations and/or associated medical tests may be required for this position Works closely and trains with the utilization management department to enable workload sharing across the disciplines Maintains regular and predictable attendance Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice Works to encourage and promote Company culture throughout the organization Other duties as may be assigned QUALIFICATIONS 3 years clinical experience required 5 years -experience in the health care industry Has current Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire PC Skills required (Basic Microsoft Office and E-Mail) Registered Nurse (RN) with active license in the state of Georgia or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law Preference will be given to candidates with Case Management experience PHYSICAL REQUIREMENTS Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required. BENEFITS 401K (4% Match, Immediate Vesting) Accident insurance Competitive salary Critical Illness Insurance Dental Insurance Employee Assistance Program Flexible Spending Account Health & Wellness Program Health Savings Account Life & AD&D Insurance Long Term Disability Medical Insurance Paid Time Off Pet Insurance Short Term Disability Vision Insurance PRE-EMPLOYMENT SCREENING Drug Screen and Background Check Required HEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYER All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.