Skip navigation
Unable to save this job. Please try again later.

{msg}

Email this Job to Yourself or a Friend

To begin the application process, please enter your email address.

Company Contact Info

  • 21650 Oxnard Street
    Woodland Hills, California, CA 91367
  • Katelyn Durkin

Already have an account?

Sign in to apply with your saved resumes.

New to CareerBuilder?

Don't have an account? Continue as a guest!

Sorry, we cannot save or unsave this job right now.

Report this Job

Trust and Site Security Team.

Email Send Failed!

Work From Home Case Manager

Medix • Woodland Hills, California, CA

Posted 25 days ago

Job Snapshot

Full-Time
$38.00 - $43.00 /Hour
Healthcare - Health Services, Pharmaceutical, Managed Care
Health Care, Pharmaceutical, Other
75+

Applicants

How Do You Compare to the Competition?

Get facts about other applicants with a CareerBuilder Account

Job Description

Screens members for possible case management services.
§ Participates in programs to proactively identify members at risk who are appropriate for case management services.
§ Reviews, screens and prioritizes cases for possible case management services.
§ Expedites access to appropriate care for members with urgent or immediate needs using expedited review process.
§ Performs prospective, concurrent and retrospective reviews and first level determination approvals for assigned members, as appropriate, or refers reviews to appropriate associate. Utilizes considerable clinical judgement, independent analysis, critical-thinking skills and detailed knowledge of medical policies, clinical guidelines and benefit plans to complete reviews and determinations within required turnaround times and regulatory requirements.
§ Works closely with delegated or contracted providers, groups or entities (as assigned) to assure effective and efficient care coordination.
§ Evaluates case management programs of delegated entities. Assesses contracted provider performance against goals on a regular basis.
§ Makes recommendations regarding oversight or joint-management of members.
§ Other Responsibilities:
§ Meets or exceeds established performance goals including but not limited to quality, productivity, turn-around time.
§ Prepares reports, data or other materials for committee presentation.
§ Provides feedback on the effectiveness of policies and procedures.
§ Effectively applies, interprets and communicates policies, procedures, clinical guidelines, medical policy, regulations and standards.
§ Reports suspected fraud and abuse as per company policy.
§ Maintains confidentiality of all PHI in compliance with state and federal law and Health Net Policy.
§ Performs all other duties as assigned.   

Job Requirements

Work From Home Case Manager

Job Description:

Medix creates opportunities for contract employees through our Healthcare, Scientific, and IT divisions. Our Healthcare division is dedicated to placing qualified professionals in the Case Management, Medical Administrative, and Insurance industries. We are seeking Work From Home Case Manager to work for our large healthcare company in the Woodland Hills, California.

 

When you choose to partner with Medix, you will experience the multiple benefits our company has to offer, starting with our excellent placement services. If you need anything, from resume tips to information on the company you’re interviewing with, your recruiter will be only a phone call away.


Case Manager, Case Management

 

Job Responsibilities

Other responsibilities of the Work From Home Case Manager role include:

  • Participates in programs to proactively identify members at risk who are appropriate for case management services.
  • Reviews, screens and prioritizes cases for possible case management services.
  • Expedites access to appropriate care for members with urgent or immediate needs using expedited review process.
  • Performs prospective, concurrent and retrospective reviews and first level determination approvals for assigned members, as appropriate, or refers reviews to appropriate associate.

Case Manager, Case Management

 

Job Requirements

As a Work From Home Case Manager, you must have a calm focus and the ability to multitask in sometimes challenging and busy circumstances. We are looking for someone who is mature, confident, and flexible with a positive attitude and strong work ethic. This position requires an individual who works quickly and goes beyond the call of duty.

Other requirements of the Work From Home Case Manager role include:

  • High school Diploma or GED required 
  • Must be certified case manager
  • Must be able to work in a fast paced environment while having strong attention to detail 
  • Ability to read and interpret department documents when required 
  • Good communication skills are required to excel in this position 


Case Manager, Case Management

 

Benefits

Once you have been a contract employee of Medix for 30 days, you become eligible for our Benefits Program. Should you elect to enroll, there are three levels of medical coverage to choose from, supplemental dental plans and term plans as well as the option to enroll your spouse and/or children. You can select the best combination that best suits your needs.

As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:

  • 401(k) Retirement Plan
  • Paid time off benefits available
  • A limited benefit medical plan with the American Worker
  • Doctor visits with inexpensive co-pay
  • Limited Outpatient Care
  • Limited Accident Coverage
  • Prescription Programs
  • Dental Plan
  • Vision Discount Program
  • Term Life Insurance Plans

 

Case Manager, Case Management

 

Medix is dedicated to positively impacting lives every day!

 

This year’s recipient of the Business Ledger's "Entrepreneurial Excellence Growth Award"

 

Join our network of talented professionals!

Apply today!

 

Keywords: Case Manager, Case Management

Help us improve CareerBuilder by providing feedback about this job: Report this Job.
CAREERBUILDER TIP
For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.