Case Manager

ATR International is hiring a Case Manager for a major client!

Major Responsibilities: Participate in managing the organization's complaint and grievance process.

• Accountable for investigation of all issues, including collection and documentation of appropriate data
• Identify and address specialty / flagged cases and follow appropriate processes for different types of cases
• Communicate with a diverse set of internal and external clientele to achieve excellent results in the areas of complaint and grievance handling, compliance, documentation and enhancement of the member experience
• Partner with and outreach to internal staff, other MS Departments, managers and physicians to resolve issues as quickly as possible
• Research, resolve and communicate complaints and grievances filed by members and communicate Health Plan's decisions appropriately back to member or their authorized representatives
• Ensure that complaints and grievances are processed in accordance with regulations, compliance standards and policies and procedures
• Answer questions and manage members on existing / open cases
• Escalate issues to management as appropriate to maintain compliance

Required Experience and Education: MSW required

• Exceptional customer service, call center experience preferred
• Write basic care plans
• Knowledge of managed care is great
• Experience in a complex health care environment preferred
• Strong working knowledge of federal and state regulations, laws and accreditation standards related to health care and managed care organizations
• Knowledge of member complaint and grievance processing preferred

Location: Pasadena, CA (Fully Remote after training)

Pay Rate: $33.58

Benefits

Full-time employees (working an average of 30 hours or more) are eligible to select from different benefits packages. Packages may include medical, dental, and vision benefits, a 401(k) retirement savings plan with employer match (available after 1 year of employment), commuter benefits, employee discount and referral programs, and life and supplemental income insurance. Paid sick leave is provided in accordance with applicable state and local laws.

Compensation

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience, as well as the benefits package you select.

Work Authorization

ATR International, Inc. cannot sponsor work visas (H-1B, F-1 STEM OPT with I-983, or similar). Candidates must have valid U.S. work authorization.

ATR International, Inc. is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.