Synergy Healthcare USA, LLC
Synergy Healthcare provides comprehensive risk management solutions that integrate health risk awareness, health coaching, health care navigation, wellness administration and on-site health care. The coordination of these service components, meaningful claim data and Synergy’s unique dedicated provider model, allows Synergy’s team members to address the often-complex needs of each individual through an experience that is compassionate, trustworthy, and simple to access.
We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees. The ideal candidate will be located in Kansas, have a thorough understanding of the healthcare system, and will be responsible for providing guidance and support to members in navigating the complex healthcare landscape. As the dedicated Nurse Advocate, you will be responsible for resolving a myriad of issues for their members and allow you the flexibility to “think outside the box”. With your clinical experience and background, you will help members better understand their health status and available treatment options. You will have a unique opportunity to develop valued relationships with members and executive teams with your specific employer clients. While this specific client is based in Kansas and they have locations in other States, this opportunity allows for remote work so can be flexible on location. Minimal travel for periodic client visits may be required. Most if not all work will be done virtually out of the convenience of your own home office. The key to your success will rely on your ability to cultivate trusted relationships with stakeholders, members, and their families. Our growing Synergy team is passionate about delivering an exceptional healthcare experience that is personal, data driven, and value based to help every person live their healthiest life.
Active nursing license with a Bachelor of Science in Nursing (BSN) degree preferred. Minimum of 3 years of experience as a nurse case manager or in a related healthcare field. CCM certification or CCM eligible. Commit to CCM exam within the first year. Bi-lingual- the ability to communicate effectively in both English and Spanish is a plus. In-depth knowledge of the healthcare and insurance systems. Strong analytical and problem-solving skills with the ability to identify and resolve complex healthcare issues. Excellent communication and interpersonal skills with the ability to interact effectively with employees and healthcare professionals. Ability to work remotely, independently, and as part of a team in a fast-paced, dynamic environment. Strong organizational skills with the ability to manage multiple tasks and priorities simultaneously. Proficient in the use of electronic health records (EHRs), Outlook, Excel, and other healthcare-related software.
Serve as the primary point of contact for members seeking assistance with navigating the healthcare system. Work with members to identify their healthcare needs and provide clinical support. Liaison with TPAs and insurance companies to resolve claim and billing issues. Educate members on their healthcare benefits and how to effectively utilize them. Advocate for members so they can receive improved healthcare outcomes, including referrals to specialists and timely access to care. Collaborate with other healthcare professionals, including physicians and nurses to ensure seamless coordination of care. Monitor member health status and progress towards achieving their healthcare goals. Maintain accurate and up-to-date records of member interactions and healthcare interventions. Client facing reporting with the potential for limited travel to client worksites. Health Risk Assessment review to encourage lifestyle modification and improve overall wellness.
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