7 Caseload Management Jobs

Role Overview: Zealie, a fast-growing Medical Billing Services company specializing in the Behavioral Healthcare industry, is seeking a Utilization Review (UR) Representative to play a crucial role in managing and coordinating authorization processes while ensuring compliance with insurance and regulatory requirements. The successful candidate will work closely with clinical teams and insurance providers to advocate for optimal patient care through advanced responsibilities and adherence to strict compliance standards and HIPAA regulations. Key Responsibilities: - Lead and Oversee Authorization Processes: Direct and manage authorization processes for assigned facilities, ensuring timely acquisition of all authorizations while following the organization's UR protocols. - Advanced Case Management: Handle complex cases requiring expertise in medical necessity and insurance protocols, including managing appeals and retro authorization processes. - Collaboration with Clinical Teams: Coordinate the level of care for patients with facility treatment teams to ensure appropriate services are authorized and documented. - Peer Review Facilitation: Coordinate and conduct peer reviews as needed, providing critical analysis to determine medical necessity. - Documentation and Compliance: Maintain comprehensive documentation of all authorization-related activities, ensuring compliance with regulatory requirements. - Patient Advocacy: Advocate for patients to ensure necessary services are covered by insurance, utilizing advanced knowledge of medical necessity criteria and insurance policies. - Discharge Coordination: Provide discharge referrals and necessary information to facilities and insurance providers for a smooth patient transition. - Utilize Advanced Technology Tools: Efficiently use industry-specific software and tools and train others as necessary. - Process Improvement: Identify areas for process enhancement within the UR function and implement changes to improve efficiency. Qualifications: Experience: - 6-10 years of Utilization Review experience, with expertise in handling complex cases. - At least 4 years of Substance Abuse/Mental Health Treatment experience, with knowledge of ASAM criteria and medical necessity standards. - Extensive experience in managing clinical appeals and navigating private insurance requirements. Education: - Bachelor's degree or higher in Psychology, Behavioral Health, or related field. - Preferred: Licensed Mental Health Clinician or Certified Addiction Counselor/Professional. Skills: - Proficiency in electronic medical record systems and UR software. - Strong leadership and mentorship abilities. - Excellent communication skills. - Exceptional organizational skills. - In-depth knowledge of psychiatric and behavioral healthcare settings. - Experience managing high caseloads and authorizations. - Understanding of behavioral health billing operations. Additional Company Details: The UR Representative role at Zealie is crucial for ensuring patients receive necessary care while navigating insurance authorization processes. This position requires expertise and a commitment to patient well-being within compliance and regulatory standards. Apply today if this opportunity aligns with your skill set and experience! Job Type: Full-time Expected Hours: 40 per week Benefits: - Health insurance - Paid sick time - Paid time off - Provident Fund - Work from home Education: Bachelor's (Preferred),

You will be responsible for drafting and negotiating a wide range of Commercial Contracts. Working closely with the Clients in-house legal departments on various matters such as international deals, bids, procurement, marketing, professional services, media, technology, or consumer matters. You will be part of a team dedicated to delivering services and ensuring compliance with all delivery commitments to the client. Managing an active caseload and adhering to all client delivery processes and commitments will be a key part of your role. Inputting and managing data on client and client systems to ensure they are up to date is essential. You will also assist in developing contract templates, playbooks, and other tools for the team's use. You will work collaboratively with the team to continuously enhance our service to the client and add value. To qualify for this position, you should have a Law Degree and/or be Legally Qualified. A minimum of 1 year of experience in drafting and negotiating commercial contracts within a law firm is required. You should be able to commit to US working hours from Monday to Friday. Having regular client-facing experience and a strong working knowledge of the Microsoft Office suite, especially Microsoft Word, is essential for this role.,

As a Lifestyle Financial Planner at Attivo, you will have the opportunity to work with a privately owned company that prioritizes the best interests of its clients and employees. Our transparent, open, and honest approach fosters trust with clients and helps them gain financial confidence. Your role will involve providing high-quality tax and Lifestyle Financial Planning services to clients, building strong client relationships, and maximizing new business opportunities while retaining existing clients. You will represent Attivo as an ambassador, embodying the company's core values and behaviors. A key aspect of the role is managing an existing client bank, with most interactions being virtual. This role supports hybrid working, allowing you to work from the office, home, and travel to meet clients as needed. To excel in this role, you should have experience delivering financial advice, excellent interpersonal and communication skills, and the ability to manage client requests efficiently. Holding a Diploma in Regulated Financial Planning and working towards Chartered status are essential qualifications. Additionally, you should be well-organized, able to work under pressure, and committed to continuous professional development. Key responsibilities include conducting detailed reviews of clients" financial circumstances, ensuring compliance with regulatory requirements, and seeking opportunities for client growth. You will also be responsible for maintaining high-quality files, adhering to AML requirements, and delivering suitability reports promptly. Essential skills and experience for this role include a Diploma in Regulated Financial Planning, proven track record in providing high-quality service and advice, strong analytical and research skills, and the ability to work independently. Desirable skills may include holding the Advanced Diploma with the CII, Chartered status, and experience with Intelliflo. Attivo offers a competitive salary of up to 60,000, with additional benefits such as a non-contributory Pension Scheme, Private Medical Insurance, Income Protection, and more. We promote a positive work culture with family-friendly policies, flexible working arrangements, and a commitment to employee wellbeing. Attivo is an Equal Opportunities employer and is dedicated to providing a fair and accessible recruitment process. Please note that any offer of employment will be subject to pre-employment vetting as required by the Financial Conduct Authority. Recruitment agencies are kindly requested not to contact Attivo regarding job postings. For more information on our privacy policy for prospective employees, please visit our website.,

The Analyst is responsible for conducting periodic reviews in line with client policy to fulfill Know Your Customer (KYC) requirements. You will be expected to deliver against targets for both productivity and quality, managing your own pipeline and taking onboard feedback from approvers who are responsible for quality checking cases. Requires the ability to work to high standards of quality in performing corporate renewal reviews of Know Your Customer (KYC) due diligence. Understand client policy and procedures and their application on client delivery. Understanding information documentation requirements for corporate structures in KYC context/evidence requirements. Requires in-depth knowledge of corporate structures i.e. privately owned or public companies, trusts, and partnerships. Proactively review and follow-up on referrals and queries. Ability to determine needs for escalation to Subject Matter Coach (SMC)/Subject Matter Expert (SME) or to the client. Manage caseload throughout the end-to-end process in a timely manner. Monitor actual performance to plan and make decisions to ensure business objectives are maintained. Source data from a number of sources/systems and accurately transfer to the primary system.,

The Analyst role involves conducting periodic reviews to comply with client policies for Know Your Customer (KYC) requirements. You will be responsible for meeting productivity and quality targets, managing your own workload, and incorporating feedback from approvers. Your main tasks will include performing corporate renewal reviews, understanding client policies and procedures, and ensuring compliance with documentation requirements for different corporate structures in the KYC context. You will need to have a deep understanding of corporate structures, such as privately owned or public companies, trusts, and partnerships. Additionally, you will be expected to proactively review and follow up on referrals and queries, escalating to Subject Matter Coaches or the client when necessary. Managing your caseload efficiently and making decisions to maintain business objectives will be crucial in this role. Another important aspect of the role involves sourcing data from various systems and accurately transferring it to the primary system. Overall, the Analyst position requires a high level of attention to detail, strong knowledge of KYC processes, and the ability to work independently while adhering to client policies and standards.,

Key Responsibilities: Assist in the Triage Team activities in resolving HR/Workday queries from colleagues and HRBPs. Address and resolve issues raised by colleagues and HRBPs promptly and effectively. Collaborate with other HR colleagues to resolve issues. Work with ServiceNow ticket system for caseload management to ensure resources are appropriately allocated. Manage leave of absence requests including maternity, LTA, paternity, and TOIL. Handle time off requests including annual leave and sick leave. Work closely with HR Workday Support Lead and HCM Workday Support Leads. Collaborate closely with the HRSS Lead. Perform any other ad hoc tasks as required. Skill required: Experience in HR. Experience in Workday system is an advantage. Strong problem-solving and query resolution abilities. Understanding of caseload management tools. Ability to work collaboratively with various HR teams. Strong organizational and process mapping skills. Strong Desire to learn.

Key Responsibilities: Assist in the Triage Team activities in resolving HR/Workday queries from colleagues and HRBPs. Address and resolve issues raised by colleagues and HRBPs promptly and effectively. Collaborate with other HR colleagues to resolve issues. Work with ServiceNow ticket system for caseload management to ensure resources are appropriately allocated. Manage leave of absence requests including maternity, LTA, paternity, and TOIL. Handle time off requests including annual leave and sick leave. Work closely with HR Workday Support Lead and HCM Workday Support Leads. Collaborate closely with the HRSS Lead. Perform any other ad hoc tasks as required. Skill required: Experience in HR. Experience in Workday system is an advantage. Strong problem-solving and query resolution abilities. Understanding of caseload management tools. Ability to work collaboratively with various HR teams. Strong organizational and process mapping skills. Strong Desire to learn.