What are the responsibilities and job description for the Case Manager position at Tops Staffing?
Case Manager (Care Coordination) Make a meaningful impact on patients’ lives by guiding them through the healthcare continuum and helping remove barriers to therapy. In this onsite Case Manager role, you’ll support customers living with chronic illness by coordinating care, navigating insurance and reimbursement requirements, and partnering closely with patients, provider offices, insurance companies, specialty pharmacies, and internal teams. You’ll use sound judgment, strong communication, and a patient-first mindset to keep cases moving forward—resolving issues efficiently while maintaining accuracy, discretion, and compliance. Required Skills Strong verbal and written communication skills with a professional, courteous approach Customer-focused mindset with the ability to build relationships across multiple stakeholders (patients, providers, payers, pharmacies, internal partners) Case coordination and follow-through skills, including triaging needs and driving timely resolution Ability to manage sensitive situations and handle opposing viewpoints with tact and discretion Working knowledge of insurance benefits, coverage requirements, and reimbursement-related processes Strong documentation habits and comfort maintaining accurate case records in a database Independent work style with the ability to juggle multiple cases/tasks and meet deadlines Mediation and problem-solving skills, including navigating approvals, denials, and appeals Nice to Have Skills Spanish language ability Experience with benefit investigations, prior authorizations, appeals, or patient assistance programs Familiarity with billing/coding nuances, payer trends, and financial assistance/charitable resources Background in customer service, medical, or insurance environments Experience supporting special projects, training/orientation, or process improvement efforts Preferred Education and Experience Bachelor’s degree (or equivalent) in a related area—preferably Health Care, Social Work, or Nursing Minimum of 3 years of recent experience with health care insurance benefits, relevant laws/regulations, and insurance processes Prior exposure to case management, utilization review, home care management, reimbursement support, or patient advocacy preferred Other Requirements Onsite role If you’re ready to help patients navigate complex coverage challenges while driving real outcomes with a team that values Passion, Innovation, Integrity, and Accountability, apply today.