Case Management Coordinator

This is a fully remote position, open to applicants in Colorado.

📋 Description

• Collaborate with county and independent case managers across multiple concurrent cases.

• Ensure timely submission of prior authorizations, reauthorizations, and appeals through Case Management Agencies.

• Act as the main point of contact for service authorizations, updates to care plans, and support during waiver transitions.

• Foster and maintain relationships with Colorado Case Management Agencies through meetings, case reviews, and collaborative resolution efforts.

• Work together with case managers and patients’ families to create care plans that meet clinical needs and comply with Medicaid requirements.

• Serve as the expert liaison for complex cases involving multiple waivers, emergency authorizations, and appeals.

• Assist with authorization operations for Colorado HCBS waiver programs including CFC, CES, and SLS.

• Develop and oversee the reauthorization process with county Case Managers to ensure continuity of care.

• Design training programs focused on Colorado-specific prior authorization guidelines.

• Provide mentorship to staff regarding the intricacies of the LTHH waiver.

• Set performance metrics aimed at achieving high approval rates and processing times under ten days.

⛳️ Requirements

• 5+ years of experience working with Colorado case managers in Medicaid LTHH environments.

• Proven track record of facilitating smooth authorizations and maintaining care continuity.

• Strong skills in relationship building, communication, problem-solving, and stakeholder engagement.

• Demonstrated ability to collaborate effectively with county-level and Case Management Agency case managers.

• Comprehensive understanding of Colorado’s LTHH framework, including HCPF policies, prior authorization processes, case coordination, and ColoradoPAR.

• Successful experience in navigating transitions and appeals within Colorado’s waiver programs.

• Background in collaborating with patient families, clinical teams, and various case managers.

• A Bachelor’s degree in Healthcare Administration, Business, or a related field is preferred.

• Colorado Medicaid certification and training in LTHH authorization are strongly preferred.

• Employment is contingent upon passing a background check, providing satisfactory references, and submitting necessary documentation.

• Candidates must indicate whether they will require sponsorship to work in the US now or in the future.

🏝️ Benefits

• Competitive salary packages.

• Comprehensive medical, vision, dental, life, and short-term disability coverage; the employer pays 90% of employee premiums and 70% for dependents.

• Numerous PPO plan options available.

• Generous paid time off policy.

• 10 paid holidays recognized by the company.

• Contributions to Health Savings Accounts (HSA).

• Optional Flexible Spending Accounts (FSA) and commuter benefits.

• Full coverage of all 401(k) account fees; however, employer matching is not currently provided.

• Paid parental leave offered.

• Options for remote work arrangements.