Case Management Associate Jobs

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications 2+ years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme

Become a part of our caring community Discover a rewarding opportunity to make a meaningful difference as a Care Coach with Humana Gold Plus-Integrated in Illinois. In this vital role, you will be at the forefront of supporting members' health and wellness by conducting comprehensive assessments, identifying needs, and guiding members and their families to essential resources for optimal care. You will report to the Manager, Care Management and join a dedicated team where your expertise helps break down barriers to effective healthcare, empowers individuals to achieve their best outcomes, and strengthens our commitment to delivering compassionate, patient-centered service. Take the next step in your healthcare career and help shape positive change in the lives of those we serve. Employs a variety of strategies, approaches and techniques to manage a member's health issues telephonically. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessments, data, conversations with member, and active care planning. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's degree in a health-related field, active Illinois LPN licensure, or the ability to obtain IL LPN license. 2 or more years of case management, medical case management, care coordination, or healthcare su

Become a part of our caring community Humana Gold Plus Integrated is seeking a Senior Care Coordinator to evaluate member's needs and requirements to achieve and maintain an optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. The Senior Care Coordinator work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Care Coordinator (SCC) will provide support to their manager by precepting, coaching, and mentoring team members. The SCC will assist in providing guidance, support, and development of processes utilized by the team as well as create supports and maintain a positive work environment. They will provide field work support to the team as needed and will monitor field work visits completed by team members. They will escalate issues to their manager as needed and support team management as requested. The Senior Care Coordinator Primary Roles & Responsibilities include: Provides coverage for Care Coordinator (CC) 1 and 2 and be able to document in the clinical system. Mentors and supports the team, as well as training initiatives. Provides daily reports to the Care Coordinators regarding outstanding cases and will review daily compliance dashboards. Supports audit initiatives and support any internal and external auditing processes for the team. Completes field work support and review reports. Supports new hire onboarding including but not limited to precepting and case audits. Coordinates services, monitors, and evaluates the case management plan against the member's personal goals. Ensures the patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversatio

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is responsible for performing utilization management (UM) reviews and authorization activities for post-acute services, including Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH), Home Health, and other post-acute levels of care. The UM Nurse Consultant evaluates medical necessity and appropriateness of services utilizing clinical criteria, applicable policies, and regulatory requirements to support quality, cost-effective care. The UM Nurse Consultant collaborates with providers, care managers, medical directors, and interdisciplinary teams to facilitate timely care transitions, ensure member needs are met, and support organizational goals. This role requires independent clinical judgment, strong critical thinking skills, and the ability to manage multiple priorities in a fast-paced environment. Required Qualifications Active, unrestricted Registered Nurse (RN) license in the state of residence. Ability to obtain and maintain additional state licensure as required by business needs. 3+ years of clinical nursing experience. 1+ years of utilization management, case management, discharge planning, managed care, or post-acute care experience. Experience reviewing medical records and applying evidence-based

Summary Join Aperia Solutions, a leader in SaaS solutions for the Payments and Compliance industries. Aperia is a Texas-based fintech and managed consultancy firm that creates custom SaaS applications and other software-based solutions for the payments, banking, and processing industry. Founded in 1999, Aperia offers business intelligence, risk management, compliance, and customer intelligence platforms. With offices in Dallas, Washington DC, and Vietnam, Aperia is a fast-paced, global organization that strives to improve efficiency in compliance, risk, and customer service operations. Aperia’s clients include banks, processors, payment facilitators, merchant service providers, independent sales organizations, and government entities. A career at Aperia promises a great challenge, culture, and opportunities to forge your own path. About the Role We are consolidating our merchant onboarding and servicing operations onto a unified Salesforce platform. The Salesforce Training & Enablement Specialist will design and deliver role-based learning that prepares our customer-facing teams to operate on the new platform confidently and effectively. This is a builder role — you will not inherit a finished training library. You will work with the CoE, Salesforce Professional Services, and stakeholders across Sales, Operations, Servicing, Onboarding, and Underwriting to create the learning experiences that drive adoption and change. The ideal candidate brings instructional design discipline, genuine customer service experience, and the ability to translate complex Salesforce workflows into persona-specific learning that sticks. What You Will Do Persona-Based Training Design Build and maintain training across four primary personas within the Pathways Learning Enablement Framework: Sales: Lead creation, application submission, rate negotiation, equipment ordering. Servicing: Account maintenance, case management, escalation handling, Onboarding / Deployment: File build, o

About Stripe Stripe is a financial infrastructure platform for businesses. Millions of companies—from the world’s largest enterprises to the most ambitious startups—use Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our mission is to increase the GDP of the internet, and we have a staggering amount of work ahead. That means you have an unprecedented opportunity to put the global economy within everyone’s reach while doing the most important work of your career. About the team and the role The People Systems Operations Administrator supports the day-to-day work that keeps Stripe’s People technology running accurately and reliably. The role sits in the Service Delivery Center and works as part of the wider People Solutions team, with a close dotted-line partnership to People Solutions Systems Management. You’ll own a defined set of routine tier 1 and tier 2 operational work across Workday and related People Systems. This includes monitoring support channels and system inboxes, triaging requests, completing repeatable administrative tasks, maintaining documentation, and routing complex issues to the right People Systems owner. This is a hands-on operations role. It creates clearer separation between routine support work and the configuration, architecture, governance, and project delivery owned by the People Systems team. What you’ll do Support queue and request triage Monitor the Salesforce case management queue and Jira requests for People Systems work. Triage incoming requests by urgency, business impact, data sensitivity, and defined support process. Resolve standard requests using documented procedures, and route exceptions or higher-complexity work to the appropriate People Systems owner. Keep request records accurate and complete, including status updates, required approvals, supporting documentation, and clear handoffs. Identify recurring request patterns and flag opportunities to improve documentation, self-serv

Atlas HXM is the global workforce platform built on compliance. We help companies determine how to engage each member of their workforce and then execute with accountability built in — direct Employer of Record (EOR), Agent of Record (AOR), payroll, and compliance capabilities backed by a decade of practitioner-led expertise. Recognized as a category Leader by NelsonHall and Everest Group, Atlas HXM builds Human Experience Management into everything we do, guided by our "For People, by People" principle. The future of work is borderless, and so are we. Our people are located around the globe — in the U.S., the UK, India, Colombia, China, and beyond. Diversity and belonging are not just values; they are who we are. We are also committed to making a positive impact. Through our Environment, Social, and Governance (ESG) impact initiative, we are addressing our environmental footprint and promoting social responsibility. Our impact program is central to our vision and culture, focusing on employee wellness, diversity, charitable work, and ethical corporate governance. About the Role We are seeking an Employee Relationship Consultant to join our global HR operations team. This role is responsible for delivering high-quality HR support across a defined region, with a focus on complex case management, compliance guidance, and employee lifecycle support. As part of our HR service delivery model, this position operates as an advanced individual contributor, supporting escalated and non-routine HR matters that require deeper expertise and judgment. The role partners closely with Shared Services and the Payroll, Benefits, and Legal teams to ensure accurate, compliant, and timely resolution of HR issues. This is a regionally aligned role that requires a strong understanding of local employment practices and language proficiency relevant to the supported geography which includes

Atlas HXM is the global workforce platform built on compliance. We help companies determine how to engage each member of their workforce and then execute with accountability built in — direct Employer of Record (EOR), Agent of Record (AOR), payroll, and compliance capabilities backed by a decade of practitioner-led expertise. Recognized as a category Leader by NelsonHall and Everest Group, Atlas HXM builds Human Experience Management into everything we do, guided by our "For People, by People" principle. The future of work is borderless, and so are we. Our people are located around the globe — in the U.S., the UK, India, Colombia, China, and beyond. Diversity and belonging are not just values; they are who we are. We are also committed to making a positive impact. Through our Environment, Social, and Governance (ESG) impact initiative, we are addressing our environmental footprint and promoting social responsibility. Our impact program is central to our vision and culture, focusing on employee wellness, diversity, charitable work, and ethical corporate governance. About the Role We are seeking an Employee Relationship Consultant to join our global HR operations team. This role is responsible for delivering high-quality HR support across a defined region, with a focus on complex case management, compliance guidance, and employee lifecycle support. As part of our HR service delivery model, this position operates as an advanced individual contributor, supporting escalated and non-routine HR matters that require deeper expertise and judgment. The role partners closely with Shared Services and the Payroll, Benefits, and Legal teams to ensure accurate, compliant, and timely resolution of HR issues. This is a regionally aligned role that requires a strong understanding of local employment practices and language proficiency relevant to the supported geography, which include

Envoy Global is a proven innovator in the global immigration space. Our mission combines our industry-leading tech platform with holistic service to streamline, simplify and expedite the immigration process for employers and individuals. Envoy Global is seeking an experienced RCIC Licensed Corporate Immigration Consultant to serve as the authorized representative for corporate clients and manage complex Canadian business immigration matters from initial assessment through final adjudication. This role is ideal for an RCIC licensed immigration professional who thrives in a client-facing environment, enjoys managing a diverse portfolio independently, and is confident providing strategic immigration guidance to employers, HR partners, and foreign national employees. You'll be empowered to exercise professional judgment, drive case strategy, and serve as a trusted advisor to some of the world's leading organizations. What You’ll Do Act as the authorized representative for corporate clients before the IRCC, ESDC, and other applicable government agencies. Independently manage a full portfolio of Canadian corporate immigration matters from consultation and assessment through application preparation, filing, and post-submission case management. Prepare and submit compliant immigration applications, including: Work Permits (GTS, LMIA-based, Intra-Company Transfers, C10/C16/C20, Free Trade Agreements) Permanent Residence (Express Entry, Provincial Nominee Programs, and Quebec immigration pathways) Employer Compliance matters, including IMP audits, compliance reviews, and disclosures Provide strategic immigration counsel regarding eligibility, application strategy, compliance obligations, timelines, and potential risks. Serve as the primary point of contact and trusted advisor for corporate clients, HR stakeholders, and foreign national employees. Analyze complex immigration scenarios and recommend tailored solutions that align with client objectives and business ne

Atlas HXM is the global workforce platform built on compliance. We help companies determine how to engage each member of their workforce and then execute with accountability built in — direct Employer of Record (EOR), Agent of Record (AOR), payroll, and compliance capabilities backed by a decade of practitioner-led expertise. Recognized as a category Leader by NelsonHall and Everest Group, Atlas HXM builds Human Experience Management into everything we do, guided by our "For People, by People" principle. The future of work is borderless, and so are we. Our people are located around the globe — in the U.S., the UK, India, Colombia, China, and beyond. Diversity and belonging are not just values; they are who we are. We are also committed to making a positive impact. Through our Environment, Social, and Governance (ESG) impact initiative, we are addressing our environmental footprint and promoting social responsibility. Our impact program is central to our vision and culture, focusing on employee wellness, diversity, charitable work, and ethical corporate governance. About the Role We are seeking an Employee Relationship Consultant to join our global HR operations team. This role is responsible for delivering high-quality HR support across a defined region, with a focus on complex case management, compliance guidance, and employee lifecycle support. As part of our HR service delivery model, this position operates as an advanced individual contributor, supporting escalated and non-routine HR matters that require deeper expertise and judgment. The role partners closely with Shared Services and the Payroll, Benefits, and Legal teams to ensure accurate, compliant, and timely resolution of HR issues. This is a regionally aligned role that requires a strong understanding of local employment practices and language proficiency relevant to the supported geography which includes

About the role We are looking for a Principal Employee Relations Partner to serve as the primary advisor and escalation point for complex employee relations issues across the organization. The role will report into the People Partner team, and act as a strategic partner to People Partners cross-functional teams, balancing risk management, compliance, and cultural alignment while fostering a fair, inclusive, and consistent employee experience. In this role, you can expect to Own the intake, assessment, investigation, and resolution of complex employee relations issues, including employee complaints, misconduct, performance concerns, policy violations, and sensitive workplace conflicts. Serve as the escalation point for high-risk or ambiguous matters, providing clear guidance on investigation strategy, risk exposure, and recommended outcomes. Conduct and oversee thorough, unbiased, and timely investigations, ensuring appropriate scoping, evidence gathering, documentation, findings, and closure aligned with Legal and company standards. Provide expert consultation to People Partners and business leaders on employee relations risks, employment law considerations, corrective action, and decision-making. Drive excellence in ER documentation and case management, ensuring accurate, consistent, and defensible records across all cases; maintain clear rationales for findings, actions, and outcomes. Analyze ER data, complaint trends, and investigation outcomes to identify root causes, systemic issues, and emerging risks, and recommend preventative or scalable solutions. Partner with People Partners to coach managers and leaders on effective conflict resolution, performance management, employee communications, and early intervention strategies. Collaborate closely with Legal, People Operations, Compliance, and Benefits to ensure equitable outcomes, alignment on policy interpretation, and consistency across the organization. Ensure employee relations programs and policies comply w

This is Adyen Adyen provides payments, data, and financial products in a single solution for customers like Meta, Uber, H&M, and Microsoft - making us the financial technology platform of choice. At Adyen, everything we do is engineered for ambition. For our teams, we create an environment with opportunities for our people to succeed, backed by the culture and support to ensure they are enabled to truly own their careers. We are motivated individuals who tackle unique technical challenges at scale and solve them as a team. Together, we deliver innovative and ethical solutions that help businesses achieve their ambitions faster. CDD Reviews Team Our Customer Risk Review team is seeking an experienced Senior CDD Risk Analyst with a strong compliance and regulatory background and deep CDD knowledge. The core impact of this role lies in the opportunity and autonomy to translate complex regulatory requirements into scalable, day-to-day operational processes. Working cross-functionally with Quality Assurance, Compliance, and Commercial teams you will shape how our team works. What You’ll Do End-to-End Case Management: Manage periodic reviews for high-risk enterprise customers, from initial assessment through final remediation. This involves conducting in-depth due diligence, analyzing complex ownership structures, and adhering to all regulatory obligations and internal policies are met within strict timelines. Uphold Quality & Consistency: Maintain "First-Time-Right" accuracy, perform regular quality control checks for the team, upskill team members on quality standards, ensure accurate risk reasoning, follow SOPs strictly, and maintain high-quality decision-making across all casework. Peer Mentorship: Coach peers, guide the team through complex cases, support upskilling team quality, and foster a culture of proactive risk management. Policy Alignment & Operational Excellence: Lead calibration sessions to translate Second Line compliance requiremen

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. ** This role requires Board Certification in a Orthopedic Spine OR Neurosurgery. ** Position Summary Aetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is a remote based (work at home) based anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs across the continuum of care. Supports the Medical Management staff ensuring timely and consistent responses to members and providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Acts as lead business and clinical liaiso

Work Flexibility: Field-based Stryker’s Neurovascular division is focused on advancing the practice of minimally invasive stroke therapies. We are mission driven to make health care better by providing innovative stroke care solutions, including clinical education and support to help physicians deliver better patient outcomes. The Clinical Specialist plays a key role in growing Stryker's stroke business by driving adoption and utilization of HEM and AIS solutions, providing expert clinical support, and partnering with customers and sales teams to deliver exceptional patient and customer outcomes. Drives adoption, utilization, and portfolio expansion of Hemorrhagic (HEM) and Acute Ischemic Stroke (AIS) products across hospital systems, partnering with Territory Managers and Territory Sales Representatives to support customer needs and achieve sales objectives. Help identify opportunities to drive adoption and growth by leveraging data and reports and collaborate with Territory Managers and Territory Sales Representatives on developing business plans. Responsible for successfully running product evaluations with the goal of account conversion. Become a Stryker expert across all HEM and AIS solutions, procedures, industry trends and competitive issues. Delivers expert clinical support and case coverage for HEM and AIS procedures while maintaining a strong focus on patient outcomes and customer experience. Deliver expert clinical support and case coverage for HEM and AIS procedures while maintaining a strong focus on patient outcomes and customer experience. May provide extended case coverage for open territories. Available to work on an on-call basis, with 50% local travel. Leads product presentations and lab staff in-servicing, providing education on case management, procedural best practices, and technique

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Program Overview: Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources Required Qualifications • Must reside in the state of Illinois •Must possess reliable transportation and be willing and able to travel up to 75% of the time from home location in and around West Suburbs IL - including DuPage, Kane, DeKalb, Kendall and surroun