Ullico
Case Manager
Bethesda, MD · Staff+
Sponsorship not specified$77k-$115kDetected 78 days ago
SpringComplianceExcelHRCustomer SupportHIPAACommunicationActuarial ScienceUnderwriting
About the role
- Union Labor Life Insurance Company is actively recruiting a Case Manager for our Silver Spring, MD office.
- Job Duties: - Analyze "trigger reports" and high dollar claim referrals to identify potential financial exposure early in the claims process.
- Troubleshoot complex clinical problems and practice independently without supervision of another licensed professional.
Responsibilities
- Performs other job-related duties that may be occasionally assigned.
Requirements
- Bachelor of Science in Nursing (BSN) or higher.
- Broad range of HIPAA regulations required.
Nice to have
- Five plus years of significant clinical experience, with backgrounds in acute or critical care being highly valued.
- Minimum of 5 years of clinical experience required
- experience in acute or critical care strongly preferred.
- Word, Excel required.
- Familiarity with Connexure ESL platform a plus.
- Knowledge and hands-on experience with PC
Compensation
- We offer a competitive starting salary and an outstanding benefits package including:
Benefits
- Review the medical necessity and appropriateness of hospital claims, physician charges, specialty drug costs, usage and provide potential alternatives.
- Apply clinical knowledge to make determinations of medical necessity.
- Apply clinical expertise to make determinations of medical necessity and manage complex clinical issues while practicing independently without supervision from another licensed professional.
This listing is sourced directly from Ullico's careers page and normalized into a canonical job model.