FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expert knowledge of managed care laws and regulations, with advanced analytical skills to identify and address nuanced details impacting case management. Proficient in organizing and prioritizing caseloads while providing technical advice and coaching to staff.
Highest-signal resume keywords
Bachelor's Degree in Healthcare ManagementRegistered Nurse (R.N.)14 Years of Case Management ExperienceExpert Knowledge of Managed Care LawsAdvanced Analytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case ManagementManaged CareAuditingData AnalysisCost-Control ProceduresNegotiationProblem SolvingPerformance ManagementOrganizing CaseloadsIdentifying System Improvements
Soft Skills
Interpersonal SkillsCommunication SkillsCoachingDiscretion
Certifications & Qualifications
Registered Nurse (R.N.)
Industry Keywords
Healthcare ManagementEmerging LegislationIndustry StandardsConfidential Information
About the role
Key responsibilities & impact- Review facility and professional bills against medical records, diagnoses, and agreements for appropriateness or inconsistencies
- Negotiate pre-surgical services
- Perform audits to identify potential leakage and system or procedural improvements
- Advise Claims staff on medical and cost-control procedures
- Provide technical advice to lower-level associates and other functional areas
- Assist with special projects
- Potentially oversee and coach staff and participate in talent selection, development, and performance management decisions
- Perform other assigned duties
Requirements
What you’ll need- Bachelor’s degree in Healthcare Management, Nursing, or a related field
- R.N. (Registered Nurse) required
- Minimum of 14 years of case management or managed care experience
- Expert knowledge of managed care laws and regulations
- Advanced ability to identify and address nuanced details impacting case management
- Expert proficiency in organizing and prioritizing caseloads
- Excellent interpersonal and communication skills
- Knowledge of emerging legislation and industry standards
- Ability to handle confidential information with discretion
- Advanced analytical skills for analyzing data, identifying problems, and developing solutions
- Subject matter expertise in the team and organization
- Must be authorized to work in the United States without current or future visa sponsorship
Benefits
Comp & perks- Medical coverage
- Dental coverage
- Vision coverage
- Wellness plans
- Parental leave
- Adoption assistance
- Tuition reimbursement
- Paid Time Off
- Paid holidays
- 401(k) plan with company match
- Employee stock purchase plan
- Commuter benefits
- Remote work flexibility, depending on availability