Case Specialist
AMERIGROUP Corporation (Nashville, Tennessee)

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Description: JOB SUMMARY:

The Case Specialist - Plan is responsible for managing care and services to members. Case Specialists works in conjunction with Case Managers to coordinate health care services by facilitating, scheduling, and arranging a variety of treatment and health care plans.

PRIMARY RESPONSIBILITIES:

1. Coordination, authorization, fulfillment, monitoring and tracking of health care services.
2. Establish working relationships with referral sources
3. Initiates and maintains contact with assigned individuals/significant others and providers to determine members response to services.
4. Coordinate home visits for Case Managers.
5. Review of benefit systems.
6. Identifies cases in consultation with Case Manager that would benefit from alternative care.
7. Coordinates assignments for Case Managers to facilitate timely member evaluation.
8. Arranges for services as identified by the case manager such as home health resources, alternative long-term care placements etc.
9. Knowledge of care-coordination and case management concepts.
10. Identifies potential liability issues for services provided.
11. Utilizes knowledge of community resources.
12. Refers members to case management as indicated.
13. Ensures that health care services are received as authorized by the provider.
14. Collaboratively works with other departments.
15. Utilizes excellent customer service principles to assist internal and external customers.
16. Maintains member confidentiality.
17. Other duties as requested or assigned. Qualifications: JOB REQUIREMENTS:

Education and Experience:
- Associate Degree required (or equivalent experience)
- Bachelors degree preferred
- Medical Terminology preferred
- Minimum of (2) years working in Health Services field
- Bilingual an asset.
.
Certification and Licensure:
- N/A.

Knowledge and Skills:
- Computer literate
- Excellent verbal and written communication skills.
- Strong decision making skills.
- Ability to provide services in an environment that involves multiple health care systems.
- Ability to interact with all relevant components of the health care system.
- Ability to provide services that deal with the individuals broad spectrum of needs
- High energy level.
- Self-starter with ability to handle multiple projects at one time.
- Appreciation of cultural diversity and sensitivity towards target population.
- Bilingual a plus.

Physical Requirements:
- Must be able to operate a computer.
- Must be able to operate a telephone. Salary/Benefits: Salary commensurate with experience AMERIGROUP Associates help make a difference in the hundreds of lives they touch every day. We understand that many of our members are moms and kids who depend on us to help them get the health care their family needs. If you share our commitment to improving people's lives, AMERIGROUP may have a place for you. AMERIGROUP Corporation is committed to associate career development and growth, providing opportunities in a culturally diverse, energetic environment. We take pride in offering extensive training programs, competitive compensation, incentives and excellent benefits including:
* Relocation Assistance
* Paid Accumulated Leave
* Holidays
* Medical Insurance
* Dental Insurance
* Life Insurance
* Short-Term Disability
* Long-Term Disability
* 401(k)
* Employee Stock Purchase Plan
* Flexible Spending Accounts
* Employee Assistance Program
* Company Sponsored Training
* Departmental Incentives
* Continued Career Growth and Development Opportunities Job Location: Nashville, TN Job Number: 8992 Company URL: http://www.amerigroup.jobs Company Profile: AMERIGROUP Corporation (NYSE: AGP), headquartered in Virginia Beach, VA, is a multi-state managed health care company focused on serving people who receive health care benefits through state-sponsored programs. From Medicaid, Temporary Assistance for Needy Families (TANF) and State Children's Health Insurance Programs (SCHIP) to Supplemental Security Income (SSI), Long Term Care and Medicare coverage, they help people of all ages get the care they need and the respect they deserve. Through its many AMERIGROUP Community Care subsidiaries, they currently help more than 1.7 million low-income Americans throughout the nation. The company operates in Florida, Georgia, Maryland, New Jersey, New York, Ohio, South Carolina, Tennessee, Texas, Virginia and the District of Columbia.

In 1994, AMERIGROUP was founded to respond to the growing need for private-sector partners in state managed health care programs for lower-income families and people with disabilities. Since its inception, AMERIGROUP has been a proven leader in meeting the states' objectives of providing accountability and improving access to health care while still controlling care costs. Today, AMERIGROUP is the largest corporation focused exclusively on the health care needs of Medicaid recipients and the uninsured.

Our mission is to operate a community-focused managed care company with an emphasis on the public sector health care market. We will coordinate our members' physical and behavioral health care, offering a continuum of education, access, care, and outcome, resulting in lower costs, improved quality and better health status for Americans.

If you share our commitment to improving people's lives, AMERIGROUP may have a place for you. We're growing dramatically and would like you to consider working for a leader in the healthcare industry. AMERIGROUP is committed to associate career development and growth, providing unlimited opportunities in a culturally diverse, energetic environment.