NOW HIRING Pharmacy Reimbursement Representatives in the Scottsdale, AZ area.
Pay Rate: $15.50 per hour
Hours: Between the hours of 6:00 am and 6:00 pm (8-hour shift) with rotating Saturdays
Job Summary:
Provide support to members and/or prescribers, and Pharmacists assisting members and/or prescribers, regarding the disease state(s) supported by the program.
The primary responsibilities are to verify insurance coverage for potential new clients.
Additionally, this person will re-verify insurance coverage for existing patients in order to process patient prescription needs successfully and demonstrate excellent customer services to patients, healthcare professionals, and insurance carriers.
Location: Must live in/near Cook County or surrounding IL suburbs
Schedule: Monday–Friday, 8:00am–5:00pm CST
Position Summary
A-Line Staffing is actively searching for 2 Field Case Management Coordinators who live in Cook County or surrounding suburbs in Illinois. This role provides field-based case management for elderly individuals and people with disabilities who have been approved for in-home or nursing facility care. Candidates must be organized, efficient, and able to work independently.
You must clearly list on your resume which ZIP code you are applying for.
Job Responsibilities
Evaluation of Members
Conduct comprehensive evaluations using care management tools and data review.Assess member needs, eligibility, benefit plans, and available resources.Identify high-risk factors and escalate to clinical case management or crisis intervention when appropriate.Coordinate and implement care plan activities; monitor progress.Enhancing Quality of Care
Use a holistic approach while collaborating with case managers, supervisors, Medical Directors, and health programs.Present cases during case conferences to support multidisciplinary review and goal attainment.Identify and escalate quality-of-care issues.Utilize negotiation skills to secure services that meet member needs.Apply motivational interviewing to maximize member engagement and lifestyle improvements.Empower members to make informed healthcare decisions.Monitoring, Evaluation & Documentation
Maintain documentation aligned with regulatory and accreditation guidelines.Follow all case management and quality management processes.MUST HAVE Requirements
Illinois resident living in/near Cook County or surrounding suburbs.Must be willing to conduct in-home member visits with travel required.Clearly list ZIP code you are applying for on your resume.Bachelor’s degree in behavioral health or human services REQUIRED