CareAllies · 2 days ago
Value Based Case Management Senior Analyst - RN - Philadelphia, PA
Philadelphia, PA
Full-time
Onsite
Mid, Senior Level
$63K/yr - $114K/yr
3+ years expCareAllies is committed to empowering its employees and fostering their growth. The Value Based Case Management Senior Analyst is responsible for managing relationships with provider practices and ensuring quality metrics are met, while coordinating cost-effective healthcare services for health plan customers.
Health CareInformation Technology
No H1B
Responsibilities
Coordinating and manage relationships with participating provider practices
Maintain detailed understanding of HEDIS / STAR performance measures
Develop and maintain a process to ensure all customers participating in provider practices meet all quality metrics
Responsible for coordinating the delivery of cost-effective, quality –based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources
Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan
Utilizes clinical skills to assess, plan, implement, implement, coordinates, monitor and evaluates options and services to facilitate appropriate healthcare outcomes for customers
Qualification
Required
Current Licensure as a registered nurse, in the state of residence in good standing
Associates degree, diploma, or B.S. in Nursing
Three to Five (3-5) years recent experience in an acute-care environment, case-management, or utilization management position (experience can be a combination of LVN/RN licensure)
Previous HEDIS and/or CMS STARs experience a plus
Preferred
Bilingual (English/Spanish)
Previous HEDIS and/or CMS STARs experience
Strong proficiency level using Microsoft Excel
Client-site Location: This is a field based position in the Philadelphia, PA market, including and surrounding cities. The individual will be onsite at provider offices 3-5 times weekly
Schedule: Monday - Friday, typical business hours
Sponsorship: Sponsorship is not available
Benefits
Health and wellness benefits
401(k) savings plan
Pension plan
A minimum of 15 days’ of paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement
Other incentives
Company
CareAllies
CareAllies works side-by-side with health care providers to help improve the quality, value and experience of care for their patients, to make health care better for everyone.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2024-01-31Acquired
Leadership Team
Elisabeth DelGrosso, MBA
Vice President, Strategy, Partnerships & Product
Joe Nicholson
Chief Medical Officer
Recent News
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