Use your health insurance and case management experience to actually change member outcomes, not just push paperwork. This fully remote Case Manager I role lets you weave together vendors, clinicians, and members to build care plans that improve health and control costs.
About Allied Benefit Systems
Allied Benefit Systems is a Chicago based benefits administrator that partners with employers nationwide to design and manage self funded group health plans. They specialize in flexible, cost effective benefit solutions backed by strong client service and clinical programs like Enhanced Case Management. Allied’s remote friendly culture is built on accountability, communication, and helping members navigate complex healthcare with confidence.
Schedule
Full time, fully remote position based out of Chicago, Illinois.
Standard weekday business hours with occasional flexibility needed to meet deadlines and member or client needs.
Home office setup with reliable high speed internet (minimum 100 Mbps download / 25 Mbps upload) required for systems access and virtual collaboration.
What You’ll Do
- Review clinical notes, claims data, and baseline case information for members across multiple health scenarios, including behavioral health, wellness, specialty prescriptions, and maternity.
- Develop strategic care plans that connect members to specialized vendor partners and Allied Care Clinicians who can best support their needs.
- Implement care plans by coordinating with members, clients, internal Allied teams, and vendor partners to keep services aligned and moving.
- Work closely with the Clinical Case Management team and other Case Managers to obtain clinical information, present cases, and collaboratively troubleshoot escalated issues.
- Communicate with the Centers for Medicare & Medicaid Services (CMS) and other carriers to obtain essential member information.
- Facilitate and maintain prescription drug vendor relationships, including member setup, ongoing support, and pricing negotiations when needed.
- Document the impact of casework to highlight both cost savings and improved member health outcomes tied to the care plan.
- Complete weekly and monthly administrative tasks to keep reporting, documentation, and workflow current.
- Serve as a liaison between clients, brokers, members, Allied executives, and internal departments to keep everyone aligned on case status and strategy.
- Identify opportunities to improve internal processes within Enhanced Case Management and across Allied departments, and collaborate on solutions.
What You Need
- Bachelor’s degree or equivalent work experience.
- At least 2 years of experience with group health insurance and self funded health plans.
- Excellent verbal and written communication skills with strong customer service instincts.
- Strong organizational skills, attention to detail, and the ability to manage multiple cases and deadlines at once.
- Demonstrated ability to review information, assess problems, and propose realistic, effective solutions.
- Solid analytical and problem solving skills.
- Proficiency with Microsoft Office Suite or similar software.
- Preferred: Experience with Medicare, Medicaid, case management, and prescription drug benefits.
- Preferred: Background in a clinical role, social work, or hospital system environment.
- Preferred: Life and Health Insurance Producer License (not required).
Benefits
- Salary range of $48,000 to $55,000 per year, based on experience and qualifications.
- Remote first culture with support to set you up for success at home.
- Medical, Dental, and Vision insurance.
- Life and Disability insurance.
- Generous Paid Time Off.
- Tuition Reimbursement.
- Employee Assistance Program (EAP).
- Technology stipend to support your remote work setup.
If you know your way around self funded health plans and want a remote role where case management actually drives outcomes, this is worth a serious look.
Put your experience to work for members who truly need an advocate on their side.
Happy Hunting,
~Two Chicks…