Job Title:

Case Manager Location:

Pittsburgh, Pennsylvania (On-Site)

Job Summary:

We are seeking a compassionate and detail-oriented professional to support patients with chronic illnesses through coordinated case management and care navigation. Our team is looking for someone who can help drive timely resolutions, strengthen communication across internal and external partners, and support positive patient outcomes through organized, compliant case coordination.

Responsibilities:

Lead care coordination efforts within an assigned territory and balance patient, physician, and program needs with sound judgment. Build and maintain effective relationships with patients, families, healthcare providers, insurance companies, specialty pharmacies, and internal teams. Manage case information accurately, including insurance coverage, approvals, ongoing requirements, and patient and provider interactions. Support insurance approvals, denials, appeals, copay assistance, patient assistance applications, prescription triage, and related education for insurance requirements and disease/product information.

Required:

Bachelor's Degree in a related area focusing on Health Care, Social Work, or Nursing preferred, or equivalent. Minimum 3 years of recent experience in the case management process preferred. Proven ability to assess the ethics and legality of patient care, with experience in case management review, utilization review, social service support, insurance reimbursement, and patient advocacy preferred. Strong verbal and written communication skills, computer literacy/data entry skills, mediation and problem-solving skills, and the ability to work independently and manage multiple tasks. In-depth understanding of health care insurance benefits, relevant state and federal laws, and insurance regulations is highly desired; Spanish language skills are 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. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from SSi People and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here: SSi People Privacy Policy