Remote Case Reviewer Jobs in Raleigh, NC (NOW HIRING)

TravelAssist Case Manager

POSITION OVERVIEW

FLSA: Exempt, Full Time

Department: Assistance Services

Primary Worksite: 6 West Colony Place, Durham, NC

Reports to: Vice President, Claims and Assistance Services

Salary: Commensurate with experience

This position is responsible for coordinating travel assistance, medical transportation, and related case management services. This isnot a Social Worker position and does not provide traditional social work services.

JOB SUMMARY

The TravelAssist Case Manager helps DAN members access their membership and insurance benefits when involved in a medical emergency while away from home. Members who need assistance call DAN's emergency hotline where queries are triaged by medical consultants who work with the treating physician to determine the medical needs and possible medical transportation needs of the member. Once a plan is finalized, the case is transferred to the TravelAssist Case Manager who is responsible for the operational execution of the mission.

Missions often begin with an emergency medical transportation to the closest medical facility. Other services include monitoring the member's condition and the mission as it progresses, keeping family members informed of the members situation, arranging follow up medical transfers, hyperbaric chamber treatments, physician visits, and more. Once the medical emergency passes, the TravelAssist Case Manager will help arrange transportation home, or to another medical facility for further care or treatment.

The TravelAssist Case Manager must exercise independent thinking and critically evaluate information to make appropriate decisions regarding mission parameters to ensure the best outcome for members.

RESPONSIBILITIES

• Coordinate and provide safe, timely, effective, efficient, and member-centered care.
• Promote quality and cost-effective interventions to improve outcomes.
• Handle case assignments, draft service plans, review case progress, and determine case closure.
• Facilitate multiple care aspects (case coordination, information sharing, etc.); interact with members to monitor their progress and ensure satisfaction.
• Work with other DAN departments to develop and maintain an international database of local providers (air ambulance, hospitals, etc.) to supplement the existing Hyperbaric Chamber and Referral Physician databases.
• Work with the DAN Medical Services department to develop clear lines of responsibility for case management and efficient SOPs for the management and transfer of cases.
• Inform members of available DAN membership and insurance benefits so the member can make informed decisions.
• Record case information, accurately complete all necessary forms, and produce reports as needed.
• Adhere to professional standards outlined by DAN's protocols, rules, and regulations.

MINIMUM REQUIREMENTS

• Proven working experience in travel assistance and/or medical case management, including expertise and knowledge in emergency/critical and acute care; medevac transport services, and understanding of flight physiology is a plus.
• Excellent knowledge of case management principles, healthcare management, and reimbursement.
• Critical, independent thinking where outcomes are often time-sensitive; must be self-motivated and able to work in high-pressure situations.
• Effective communication skills, verbal and written, to build and maintain internal and external relationships.
• Excellent organizational and time management skills, with the ability to multi-task, problem solve, prioritize, delegate, and meet critical deadlines.
• Compassionate, with teamwork skills.
• Typing and computer skills with proficiency in Microsoft Office software.
• Bachelor's degree in the healthcare field or equivalent experience.

WORKSITE

The primary worksite is the DAN office in Durham, North Carolina. Following an introductory period (3 - 6 months), this position will be eligible for telecommuting or a remote work arrangement. Details will be discussed during the interview process