Healthcare Case Manager

1 week ago

Canada VIVIO Health Full time

VIVIO Health is dedicated to harnessing data for informed clinical decision-making.

The Healthcare Case Manager will utilize their case management expertise to resolve complex challenges in a fast-paced environment. To excel in this role, one must possess effective case management skills, strong communication abilities, empathy and compassion, thorough assessment and evaluation of member therapy needs, provider coordination, and efficient time management to ensure accurate processing of information for new and existing members.

Key Responsibilities:

  • Assume ownership for managing new and existing therapy requests.
  • Comprehensively assess member treatment needs and collaborate with providers and specialty pharmacies to prioritize therapy requirements.
  • Maintain accurate and detailed documentation of all interactions and therapy updates.
  • Continuously monitor and evaluate member therapy plans and progress.
  • Balance multiple responsibilities including case management, inbound and outbound contact while demonstrating adaptability to ensure seamless service delivery.

Member Advocacy:

  • Take the time to understand each member's unique needs, preferences, and circumstances.
  • Advocate for members' needs and preferences in therapy decision-making processes.
  • Support members in navigating barriers and explain their options for receiving medications.
  • Provide members with information and resources to facilitate informed decisions about therapy options.
  • Empower members to participate actively in their treatment planning and decision-making process.

Case Resolution and Problem-Solving:

  • Resolve member cases and inquiries efficiently, demonstrating strong critical thinking skills and attention to detail.
  • Review and resolve next-level questions or concerns from members, providers, and pharmacies.
  • Evaluate scenarios critically, anticipate potential challenges, and adapt your approach to meet evolving member needs effectively.

Communication and Collaboration:

  • Communicate member progress by proactively informing members of their therapy status and intervening in crises providing personalized communication.
  • Manage communication with providers and consistently ensure professional and empathetic interaction fostering positive relationships and ensuring high member satisfaction.
  • Collaborate closely with other departments to coordinate resources and address member inquiries or concerns effectively.

We offer a competitive salary ranging between $60,000 - $80,000 per annum, commensurate with experience, plus benefits.

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