It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
As a Case Management representative at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve - a community's most vulnerable.
Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges.
Gainwell empowers you to help clients deliver better health and human services outcomes using innovative technology and solutions, enabling you to design your career for growth, new possibilities, and refinement of your valuable skills. Here are the details on this position.
Your role in our mission
* Intake and evaluation of members for case management
* Collaborate with multi-disciplinary team to perform risk assessment, implement and monitor plan of care
* Schedule and coordinate complex treatment plans involving dental and medical providers. Make referrals to appropriate clinical specialists
* Obtain authorizations and approvals for medically necessary dental care. Assist with obtaining supporting ancillary services
* Monitor members adherence to treatment, appointments, and receipt of care. Update and adjust plan of care as needed. Record case information, accurately complete all necessary forms and produce
statistical reports/information as needed
What we're looking for
* Proven work experience in Case Management with a preferred minimum of three (3) to five (5) years of experience in a relevant Case Management position in the healthcare or insurance industry with
Medicaid and/or Medicare knowledge and experience strongly desired
* Previous lead or management experience in monitoring performance standards of a team and supporting client escalations
* Clinical and/or Dental health experience is preferred. Strong knowledge of dental treatment authorization request processes, procedures, and documentation is preferred
* Professional or personal experience supporting individuals with disabilities, chronic illnesses, or experiencing homelessness preferred Highly organized with a strong ability to manage different priorities
* Ability to work with others and use resources to problem solve
* Apply good judgment to fast-changing situations
* Effective verbal and written communication skills, exceptional interpersonal, customer service, negotiation, and problem-solving skills.
* Ability to build relationships with different types of people, including clients, caregivers, family members, community-based organizations, and members of the health care
* Collaboration across teams
* Strong understanding of cultural and linguistic competency
* Education and experience: LMSW/LCSW/LMHC or RN/LPN degree
* Must be a resident of California
* Ability to work in a hybrid environment 2 -3 days/week, located in Roseville, CA.
#LI-HYBRID
#LI-SA1
#LI-MN
The pay range for this position is $69,100.00 - $98,700.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.