Insurance Case Manager Jobs in Seattle, WA (NOW HIRING)

Description

The Medical Case Manager at Key Works provides coordination and support for patients' medical and healthcare-related needs. This role works closely with medical providers, general case managers, and support staff to ensure patients receive timely, organized, and effective care of coordination. The Medical Case Manager also supports the development and improvement of workflows and processes that strengthen the organization's medical support services.

Primary Responsibilities

• Coordinate STI testing, lab work, and phlebotomy services for patients.
• Review After Visit Summaries (AVS) and Primary Care Provider (PCP) recommendations with Medical Officer and the General Case Manager.
• Provide telehealth support and assistance to patients as needed including recording pt AVS and communication pt status to remote provider.
• Assist patients with medication refills and troubleshoot pharmacy-related concerns with Omnicare Pharmacy.
• Support Key Works Health Team, medical providers, and other providers with patient care coordination and communication.
• Assist in scheduling, follow-up coordination, and communication between patients, providers, and case management staff.
• Ensure patient medical needs and provider recommendations are clearly communicated to the General Case Manager for implementation and follow-through.
• Maintain accurate documentation and support continuity of care within the Key Works care model.

Medical Assessment and Referral Process

Patients with medical concerns or healthcare-related needs will be referred to in-medication PA for assessment and evaluation. Following the assessment, in-house PA will identify patient needs and provide recommendations for care, treatment coordination, or follow-up services.

The Medical Case Manager will support communication of these recommendations to the General Case Manager and assist with coordination to ensure the care plan is implemented appropriately and effectively.

Process Development and Operational Support

The Medical Case Manager is expected to identify opportunities for workflow clarification, process improvement, and operational development that strengthen the medical support function at Key Works. This includes:

• Assisting in the development of clear workflows and coordination procedures.
• Supporting communication processes between medical providers and case managers.
• Identifying gaps or barriers that impact patient care coordination.
• Helping build systems that improve efficiency, follow-up, and continuity of care.
• Contributing to the continued growth and effectiveness of the medical case management role within the organization.

Goal of the Position

The overall goal of the Medical Case Manager role is to support patient wellness through effective medical coordination, provider collaboration, organized follow-up, and improved healthcare navigation while strengthening the integration between medical services and case management support at Key Works.

Requirements

Education and Experience:

• Experience in case management, care coordination, or medical operations required.
• Case management certification (e.g., CCM, CMC, or AADAC) or medical assistant training preferred.
• Minimum of 2-3 years of experience in addiction treatment, mental health, or healthcare settings.

Skills:

• Strong case management and organizational skills.
• Strong ability to track needs of multiple individuals, such as ongoing appointment scheduling and medication prescription renewal needs.
• Knowledge of medical, psychological, and addiction treatment processes.
• Understanding of Medication Assisted Treatment.
• Excellent communication skills to interact effectively with patients, families, healthcare team, and other agencies as a Key Recovery representative.
• Problem-solving and critical thinking abilities to address complex care needs.
• Empathy, patience, and strong interpersonal skills to build rapport with patients in recovery.

Certifications:

• CPR and First Aid certification may be required.

Physical Demands:

The duties require sitting, standing, walking, stooping, bending, smiling, kneeling, reaching, pushing, pulling, twisting, ability to grip with hands and fingers. Ability to hear and speak conversationally, fluent in English occasionally lifting up to 25 pounds. Must be able to climb stairs without an elevator.

Benefits: 

Join our team and enjoy a comprehensive benefits package designed to support your well-being and career growth. This includes: 

Healthcare: Company-paid medical, along with dental, and vision insurance with employer-sponsored wellness programs.

Paid Time Off: Generous vacation, sick leave, and 10 paid holidays, plus a flexible work schedule to accommodate your needs.

Retirement: 401(k) with company matching

Professional Development: Access to industry-leading training and conferences, as well as tuition reimbursement for relevant courses.

Employee Discounts: Enjoy discounts on a variety of products and services, including travel, entertainment, and technology.