The Case Manager RN is responsible for coordinating care for Special Needs Plan members facing complex medical and behavioral health conditions, often involving social determinants of health needs. This involves conducting comprehensive assessments, developing individualized care plans, providing education, monitoring progress, and connecting members with necessary resources, with 50-75% of the day dedicated to telephonic engagement.

The representative will provide routine service support to customers contacting the Customer Care Center regarding products, online directions, and accounts, communicating with customers and service partners to resolve issues. They will perform customer service activities across multiple channels, resolve inquiries, recommend solutions, and document interactions to maintain high customer satisfaction.

The associate will handle dealer resolutions, provide support for Dealer Navigator and products via call/chat, execute end-to-end billing support, and utilize resources to ensure effective onboarding and servicing across all case types. Responsibilities also include fostering vendor relationships, managing workload effectively, and investigating issues to mitigate defects and dissatisfaction.

The coordinator will manage the full lifecycle of Durable Medical Equipment (DME) referrals, including communication of status, ensuring payor authorization before delivery, and confirming final equipment delivery to injured workers. This involves close partnership with referral sources, patients, and DME providers to maintain timeliness, accuracy, and high customer satisfaction.