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Benefits Case Manager

Company: J.B. Hunt Transport Services, Inc.
Location: Lowell
Posted on: June 22, 2022

Job Description:

In coordination with Sr. Case Manager, Benefit Management staff and vendor partners, identify and make recommendations for care coordination with benefit program resources; monitor, and prepare data for reporting of various program engagement and cost; With Sr. Case Management oversight, work closely with vendor contacts to build and maintain working relationships; provide and coordinate program education initiatives to support department staff.Key Responsibilities:

  • Identify candidates for care under applicable benefit programs
  • Support facilitation of care process with insured member, plan administrators, and provide support for clinical transitions, as necessary, as it relates to benefit coverage, authorizations, etc.
  • Maintain and gather data in preparation for management development and reporting of cost data associated with applicable benefit program administration
  • Gather details in effort to identify and communicate potential financial exposure associated with chronic care needs or potential high claim cases.
  • Assist with claim appeal process; gather information and prepare for review and evaluation in keeping with applicable benefit plan guidelines, and present claim appeals to the Appeal Review Board, providing clinical insight specific to each case
  • Assist in claimant response, keeping with applicable benefit plan guidelines
  • Provide guidance, as needed, in effort to maintain compliance with applicable plan documents
  • Provide targeted, personalized service based on a holistic view of the member, benefits, health information, and through engagement.
  • Handle customer service inquiries and problems via telephone, internet, web-chat or written correspondence.
  • Utilize all relevant information to effectively influence member engagement and provide consult based upon the member's unique needs and preferences
  • Provide education for understanding of benefit plans, tools and resources to help guide members in accessing benefits and appropriate resources.
  • Provide appropriate support in vendor audits when required.
  • Document and tracks all contacts, events, and outcomes using appropriate systems and processesMinimum Qualifications:
    • Bachelor's degree (B.A.) or equivalent from four-year college or university; two years related experience and/or specific training; or equivalent combination of education and experience and one year management experience; experience in a clinical setting.
    • Ability to research data and know where to obtain data.
    • Ability to deal effectively and tactfully with customers and vendors, dealing with highly sensitive and confidential information.
    • Ability to make decisions in a timely and professional manner, plus have analytical ability, initiative and problem-solving ability.

Keywords: J.B. Hunt Transport Services, Inc., Springdale , Benefits Case Manager, Executive , Lowell, Arkansas

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