Personal Injury Case Manager - Part-Time

Personal Injury Case Manager

Join our team as a Personal Injury Case Manager. This part-time position is not remote and requires working three days a week from 7:30 AM to 4:30 PM. The Personal Injury Case Manager serves as a subject matter expert regarding internal Personal Injury processes and procedures, acting as a resource for Patient Advocacy Specialists. With a primary focus on facilitating the patient's recovery, this role demands excellent communication, documentation, and follow-up skills throughout the management of each assigned case.

Job Description

• Provides medical case management to individuals through telephonic communications with the patient, physician, other health care providers, and others.
• Proactively manages all active cases to assess progress/response to treatment, prevent lapses or delays in treatment, obtain regular updates, and facilitate the patient's recovery plan.
• Schedules medical appointments via the PHS scheduling tool as requested and directed by PHS clients and referred patients in a timely manner.
• Updates clients regarding status when patient expenses are nearing the maximum allotment to receive direction for next steps, such as increasing the dollar amount assigned to the case or closing the case.
• Refers out-of-network providers to the Provider Negotiations Specialist to obtain a single case agreement and to the VP of Network Development to contract the provider to the PHS network.
• Serves as the go-to person for other members of the Patient Advocacy Specialist team.

Requirements

• An active Tennessee license (in good standing) as a Licensed Practical Nurse or a Registered Nurse, or a Bachelor's Degree in Social Work - Licensed Clinical Social Worker (LCSW) is preferred.
• One year of direct work experience in case management, patient scheduling, personal injury, utilization review, and managed care in a healthcare setting.
• Demonstrated proficiency in Microsoft Office (Word, PowerPoint, Excel, Teams).
• Certification in case management and prior experience in cost containment are preferred.
• Bilingual in Spanish/English is preferred.

Case Manager Competencies

• Detail-focused with the ability to multi-task and adhere to established goals; results-driven.
• Ability to work in a fast-paced, changing environment; flexible to meet business needs.
• Excellent communication skills (oral and written); ability to maintain confidential information.
• Superb organizational, problem-solving, and time management skills; team player.
• Ability to maintain a calm and professional demeanor in stressful situations.

Benefits

• Medical insurance (high deductible plan with an HSA).
• Dental insurance.
• Vision insurance.
• Short-term and long-term disability paid by the company.
• Group term life paid by the company.
• PTO - 160 hours (4 weeks) with the ability to roll over 40 hours and cash out 40 hours at the end of the year.
• Fitbit program with monetary rewards.
• Employee recognition programs with monetary rewards.
• Corporate office amenities - specialty coffee machines, assorted tea options, smoothie bar, collaborative workspaces, fruit provided by the company, and an onsite market.
• Regular employee events such as potlucks, video game tournaments, door decorating contests, Mental Health Awareness Month activities, and a company carnival.

About Us

Prime Health Services (PHS) is a national medical cost containment company with a noteworthy PPO network used by insurance carriers, TPAs, self-insureds, and governmental entities. Our tech-focused nature allows clients to take advantage of the flexibility of customization while not compromising on bill processing speed. Since 2001, we have specialized in medical provider network development and offer clients a tailored approach to medical cost containment: quality health care at discounted rates.