Support members through complex health journeys while working from home. In this role, you help connect people to the right care, manage benefit partners, and make a real impact on health outcomes and costs.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator that partners with employers to design and manage flexible, self-funded health plans. The company focuses on delivering smarter, more personalized benefits solutions that improve member experiences and manage costs. As part of the Medical Management team, you’ll help drive better clinical and financial outcomes for members and clients.
Schedule
- Full-time, fully remote position
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture with strong emphasis on communication and collaboration
- Must have reliable cable or fiber internet with minimum speeds of 100 Mbps download / 25 Mbps upload
What You’ll Do
- Review clinical information, claims, and baseline case details for a variety of health scenarios (Behavioral Health, Wellness, Specialty Rx, Maternity, and more)
- Develop strategic care plans that connect members with specialized vendor partners and Allied Care Clinicians
- Implement care plans by coordinating with members, clients, internal Allied staff, and external partners
- Partner closely with the Clinical Case Management team and other Case Managers to gather clinical information, present cases, and troubleshoot escalated issues
- Communicate with CMS and other entities to obtain essential member information
- Facilitate and maintain relationships with prescription drug vendors, including managing member setup, negotiating pricing when needed, and providing ongoing support
- Document case impacts to highlight cost savings and improved member health outcomes
- Perform weekly and monthly administrative tasks related to Enhanced Case Management
- Act as a liaison between clients, brokers, members, Allied Executives, and various internal departments
- Help identify, troubleshoot, and optimize internal processes across Enhanced Case Management and related teams
- Perform other duties as assigned to support the ECM strategy and operations
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
- Strong interpersonal and customer service skills
- Exceptional organizational skills and attention to detail
- Proven time management skills with the ability to meet deadlines
- Ability to review information, assess issues, and propose viable solutions
- Strong analytical and problem-solving skills
- Experience with Medicare, Medicaid, Case Management, or prescription drug benefits preferred
- Experience in a clinical, social work, or hospital system role is a plus
- Life and Health Insurance Producer License preferred, but not required
- Proficiency with Microsoft Office Suite and comfort learning new software
Benefits
- Salary range of $48,000–$55,000, depending on experience and qualifications
- Comprehensive Total Rewards package
- 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’re ready to use your healthcare benefits expertise to guide members toward better outcomes in a fully remote role, this is a strong next step.
Give your skills a promotion—step into a case management role where your coordination actually changes lives.
Happy Hunting,
~Two Chicks…