Allied Benefit Systems ยท 1 day ago
Manager, Enhanced Case Management
United States
Full-time
Remote
Mid, Senior Level
$75K/yr - $85K/yr
5+ years expAllied Benefit Systems is a company focused on healthcare solutions, and they are seeking a Manager for their Enhanced Case Management program. This role is responsible for leading the development and continuous improvement of the ECM program, ensuring high-quality care coordination and advocacy for members with complex health needs.
Health CareInsuranceWellness
Responsibilities
Develops and directly manages Enhanced Case Management Advocates and Supervisors, while providing indirect oversight to the Case Managers through supervisory staff. Monitors department dashboards and conducts case audits to ensure teams consistently meet or exceed quality standards and KPIs
Fosters a collaborative, continuous improvement environment and supports staff in resolving challenges and enhancing performance through constructive, supportive feedback
Engage with the Client Management and Value Team to offer insight related to high-dollar claimants and provide a clear explanation of ECM strategies, efforts, and impact
Identify members from our ASO Self-Funded and Co-Sourcing Partially Self-Funded Clients based on current medical condition(s), future claim costs, and current financial assessment for Enhanced Case Management evaluation and identify strategic solutions
Maintain continuous knowledge of Medicare, Medicaid, and other government programs, including application processes, eligibility criteria, dual eligibility, and coordination of benefits (COB)
Identify trends and opportunities to collaborate with Medical Management leadership to enhance processes and strategies to improve quality, efficiency, and outcomes
Manage a case load of high-complexity members to support their needs, evaluate coverages and offer resources
Promotes an environment of continuous improvement and collaboration and assists in troubleshooting and resolving escalated challenges quickly by utilizing an empathetic approach
Coordinate with Client Management and other internal departments to answer questions and resolve client challenges
Assist in selecting and building the right teams to meet long-term talent planning needs and achieve business goals
Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent
Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed
Actively engage, coach, counsel and provide timely, and constructive performance feedback
Performs other related duties as assigned
Qualification
Required
Bachelor's degree or equivalent work experience required
At least 5 years of Case Management experience, preferably from a third-party administrator, carrier, or within the healthcare industry required
At least 3 years at a supervisor level and successfully demonstrated leadership competencies required
Demonstrated expertise in Medicaid, Medicare, eligibility processes, and coordination of benefits
Experience managing teams of employees with a variety of backgrounds and tenure
Ability to monitor and prioritize multiple deadlines and projects simultaneously
Excellent written and verbal communication skills with the ability to influence cross-functionally and present to clients/leadership
Proven experience building training programs, conducting audits, and providing structured feedback
Preferred
Experience reading, analyzing, and reviewing organizational metrics and data, preferred
Benefits
Medical
Dental
Vision
Life & Disability Insurance
Generous Paid Time Off
Tuition Reimbursement
EAP
Technology Stipend
Company
Allied Benefit Systems
Allied offers insurance products, self-insurance solutions, custom insurance and healthcare solutions to the individuals and organizations.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Stone Point Capital
2021-02-18Private Equity
Leadership Team
D
Dina H. Tank
Senior Vice President of Sales, Western Region
Recent News
2025-06-04
2025-06-03
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