Case Manager – Maternity

Allied Benefit Systems

. Help members navigate healthcare needs by coordinating care plans and connecting them with clinical resources, specialized services, and vendor partners.

Posted 10/24/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $50,000 - $55,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in coordinating care plans and connecting members with clinical resources, while effectively communicating with various stakeholders. Proficient in analyzing clinical documentation and managing relationships with vendors to optimize member health outcomes.

Highest-signal resume keywords

Care Plan CoordinationGroup Health Insurance ExperienceAnalytical Problem-Solving SkillsMicrosoft Office Suite ProficiencyExcellent Communication Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Clinical Documentation ReviewCase ManagementBehavioral Health KnowledgeSpecialty Prescription ManagementCost Savings Documentation

Soft Skills

Interpersonal SkillsCustomer Service SkillsOrganizational SkillsTime Management SkillsAttention to Detail

Certifications & Qualifications

Life and Health Insurance Producer's License

Industry Keywords

MedicareMedicaidSelf-Funded Health PlansHospital System ExperienceVendor Management

About the role

Key responsibilities & impact

Help members navigate healthcare needs by coordinating care plans and connecting them with clinical resources, specialized services, and vendor partners.
Review clinical documentation, claims, and baseline case information for behavioral health, wellness, specialty prescription medications, maternity, and other health needs.
Develop strategic care plans and connect members with specialized vendor partners and Allied Care Clinicians.
Implement care plans by coordinating with members, clients, Allied staff, and vendor partners.
Collaborate with the Clinical Case Management team and other case managers to obtain clinical information.
Present cases to collaboratively identify and resolve escalated casework issues.
Communicate with CMS to obtain essential member information.
Facilitate and maintain relationships with prescription drug vendors, negotiate pricing as needed, manage member setup, and provide ongoing support.
Document casework impact, including cost savings and improvements in member health outcomes.
Perform weekly and monthly administrative tasks.
Serve as a liaison among clients, brokers, members, Allied executives, and Allied departments.
Identify and troubleshoot process issues and collaborate to optimize internal processes.
Perform other duties as assigned.

Requirements

What you’ll need

A bachelor’s degree or equivalent work experience is required.
Two years of experience with group health insurance and self-funded health plans required.
Excellent verbal and written communication skills.
Excellent interpersonal and customer service skills.
Excellent organizational skills and attention to detail.
Excellent time management skills, with a proven ability to meet deadlines.
Ability to review information, assess problems, and propose viable solutions.
Strong analytical and problem-solving skills.
Proficiency with Microsoft Office Suite or related software.
Experience with Medicare, Medicaid, case management, and prescription drug benefits preferred.
Experience in a clinical or social work position is a plus.
Experience working in a hospital system is a plus.
A life and health insurance producer’s license is preferred but not required.