Job Title: Case Manager
Location: Pittsburgh, Pennsylvania (On-Site)
Job Summary: We are seeking a Case Manager to support customers with chronic illnesses by coordinating care, navigating insurance processes, and helping remove barriers to timely therapy. This role plays a key part in maintaining effective communication across patients, families, healthcare providers, insurers, and specialty pharmacies while helping drive positive outcomes.
Responsibilities:
- Lead care coordination activities within an assigned territory and balance patient, provider, and program needs with sound judgment.
- Build and maintain professional relationships with internal and external stakeholders, including patients, families, healthcare providers, insurance companies, and specialty pharmacies.
- Manage patient records and related database information, including coverage approvals, insurance details, ongoing requirements, and interaction history.
- Support insurance approvals, appeals, copay assistance, patient assistance applications, prescription ordering or triage, and education on insurance and disease/product information.
Required:
- Bachelor’s degree in a related area focusing on Health Care, Social Work, or Nursing preferred.
- Minimum 3 years of recent experience in the case management process preferred.
- Proven ability to assess the ethics and legality of patient care.
- Strong verbal and written communication skills, computer literacy, patient advocacy, case management expertise, mediation, problem-solving, data entry, and the ability to work independently on multiple tasks.
- Experience in home care management, case management review, utilization review, social service support, insurance reimbursement, and patient advocacy preferred.
- In-depth understanding of health care insurance benefits, billing/coding nuances, insurance regulations, and relevant state and federal laws highly desired; Spanish language proficiency is a plus.
About SSI People: With over 26 years of industry experience, SSi People has built its reputation and expertise on putting people first. Everything we do works toward delivering exceptional experience for our consultants, our clients, and our internal team. Through a genuine commitment to people in everything we do. We have developed refined processes and a stellar internal team to deliver talent quickly. More importantly, we focus on building long-term relationships, not transactions. Putting people first is just what we do well.
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