Senior Case Manager Resume Samples

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A Kuphal

Ashley

Kuphal

70108 Predovic Glen

Phoenix

+1 (555) 187 3848

70108 Predovic Glen

Phoenix

Phone

p +1 (555) 187 3848

Experience Experience

Chicago, IL

Senior Case Manager

Chicago, IL

Hartmann Group

Chicago, IL

Senior Case Manager

Providing feedback and lessons learned to inform ongoing development and refining of policy standards and control options
Working closely with your Injury Management Advisor and Technical Manager to produce a return to work or review of entitlement
Providing Workers’ Compensation claims and return to work advice to all stakeholders and participate in claims reviews
Developing, facilitating and implementing outcome based claims
Implementing medical and like cost management strategies on claims
Providing a cost effective, professional and customer focused workers compensation claims service through managing claims, identification of claims with escalating risk, management of liabilities, delivery of high quality service levels and a commitment to learning and development
Candidates with nursing, physiotherapy, rehabilitation, chiropractor, allied health or medical background who are looking to make a career change are also encouraged to apply

Los Angeles, CA

Icg-kyc-senior Case Manager

Los Angeles, CA

Schmitt-Carter

Los Angeles, CA

Icg-kyc-senior Case Manager

Effective and close communication with KYC Owners, Makers, Compliance to improve KYC record quality
Assist in root cause analysis by identifying & analyzing areas of common defect/issues/themes
The CitiKYC In-Process Checker will serve within the ICG KYC Quality Assurance Review Team. The team is tasked with ensuring high quality within KYC records, focusing on accuracy, completeness, and consistency of KYC records and in adherence to KYC policies
Assist with department projects/initiatives as requested
Participate in ad hoc projects related to quality improvements
Work with colleagues within the Business Support Unit (BSU) and AML Compliance to resolve KYC issues
The objective is to improve the quality of the KYC Records

present

Boston, MA

Basu Cadd-senior Case Manager

Boston, MA

Lemke, Bergnaum and Harber

present

Boston, MA

Basu Cadd-senior Case Manager

present

Meet Case Managers on daily basis to discuss WIP KYC Records and for provide feedback to them based on records checked
Point of escalation for Case Managers, Relationship Managers team and Compliance within cluster / region
Assist with the preparation for audits– both internal and external regulatory reviews
Returns the KYC Records to BSU Case Manager if not complete
Mentor and coach Case Managers & New SCMs on an ongoing basis
Responsible for checking all KYC Records within team, and capturing rejection reasons per record checked
Develop coverage/succession plan for out of office/ holidays and vacation scenarios

Education Education

Bachelor’s Degree in Education

Northwestern University

Bachelor’s Degree in Education

Skills Skills

Solid knowledge of medical terminology together with significant understanding of how various medical conditions affect ability to work
Ability to apply detailed knowledge of organizational procedures to make independent decisions and serve as a credible resource for a senior management team
Excellent communication skills – ability to communicate at all levels within the organisation
Good knowledge of English Language
Accuracy and strong attention to detail
Solid technical knowledge
Valid drivers license and/or dependable transportation necessary (variable by region)
Strong financial analysis skills with a proven ability to review, understand and interpret financial accounts, management accounts and budgets
Excellent problem solving skills with ability to analyze situations, identify existing or potential problems and recommend solutions
Up to date knowledge of applicable regulatory code and application of MARP strategies

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Senior Case Manager Resume Examples & Samples

Customer Relations Operational Accountabilities
Ensure all telephone calls/emails and correspondence received are answered or responded to in a timely manner and all customer contact is recorded in the appropriate systems
Responsible for identifying, analysing and reporting on serious/possible systemic issues
Identify and report possible preventable complaints and ensure appropriate coaching is provided
Customer& Relationship Engagement Accountabilities
Actively participate in mediation and conciliation of the complaint cases with FOS
Build relationships within business units and FOS or COSL
Manage and minimise potential escalation of complaints to the media avoiding litigation
Participate in improvement initiatives and make proactive constructive improvement recommendations
Strong customer orientation along with customer advocacy skills and ability to problem solve (work and think outside the square)
Ability to make independent, impartial and fair decisions in dispute matters
Ability to self-manage
Excellent time management, business writing and communication skills
Proven negotiation and mediation skills and the ability to stay calm and constructive under pressure
Ability to develop and deepen stakeholder relationships
Tertiary / T.A.F.E. HSC (or equivalent)
Previous sales / industry experience
Accreditation in mediation – highly regarded
Knowledge of Code of Banking Practice/EFT/privacy legislation

Senior Case Manager Complaints Resume Examples & Samples

Responsible for the acceptance, investigation, and fair and timely resolution of complex complaints received from FOS and COSL
Work effectively with the relevant business units and FOS or COSL to obtain required account information for the resolution of a case within agreed SLA time frames
Undertake process improvement related projects which are focused towards providing a seamless customer experience
Develop empathy and rapport with customers and set and meet customer expectations during the resolution of problems and complaints and promote Citi Brand and Values in all interactions
Knowledge of external EDR (External dispute resolution) schemes (FOS/FICS/VCAT/Privacy/ASIC/Fair Trading)

Senior Case Manager Resume Examples & Samples

Holistic Claims Management
Customer Commitment
Holistic review and end-to-end management of cases, incorporating all available information, assessing against terms and conditions of the policy, with a focus on identifying and driving personalised outcomes for each customer
Active communication with the employer to gather information on occupational demands and duties
Partnering with healthcare providers to exchange information around occupational details
Developing tailored case management plans by formulating evidence based strategies for managing the case toward the optimal claim outcome

Senior Case Manager Resume Examples & Samples

Receives and reviews incoming new insurance applications for completeness
Review all applications for appropriate supporting suitability and replacement documentation
Performs other duties as assigned such as: Peer mentoring, special projects and training
Conducts regular follow-up on cases via phone primarily and email and/or fax secondarily, on all outstanding requirements with insurance business partners and clients
Follow up with insurance producers on policy delivery requirements, including application amendments, health statements, delivery receipts, illustrations, and premium payments to ensure policies are placed within specified timeframes
Partner with management team members to recommend improvements in procedures to improve efficiencies and increase number of cases issued
Five (5) or more years of Case management experience within the financial services industry
Has LOMA or must attain 1 & 2 within one year of hire
Thorough understanding of state & regulatory guidelines including replacements & suitability
Superior written and verbal communication skills; must poses a keen ability to communicate via e-mail in a clear, concise and professional manner
Self-directed: able to multi-task, prioritize and manage multiple requests with minimal supervision

Senior Case Manager Resume Examples & Samples

Serves as a patient advocate by communicating with insurance companies, 501c3 organizations as well as any other organizations offering services to patients in need
Conducts research, manage patient records, and organizes documentation for the purposes of providing patient assistance
Guides patients through enrollment periods through both commercial and government payers as well as nonprofit organizations offering assistance
Collaborates with other members on the Patient Services Team for the purposes of updating patient status’ currently in Financial Case Management
Monitor and work with patients approaching Medicare eligibility to ensure appropriate placement in Parts A, B, & D plans as well as supplemental and Gap coverage where necessary
Coordinate and manage all eligible patient referral/enrollment into the Cinryze Financial Assistance and PAP Program
Act as single point of contact within Patient Services team to provide updates and status on all eligible patients referred to vendor for financial assistance
Maintain communication and interaction with patients, payers, and medical providers in order to address issues impeding optimum treatment goals
Routinely meet with Managed Markets and Corporate Account Directors as well as support other internal teams to ensure all business objectives are being met
Research available commercial and government sponsored programs across all 50 states and Puerto Rico to be housed in a warehouse database for informational use and guidance
Provide back-up coverage for other Financial Case Managers
Attend patient meetings and represent the foundation at industry conferences
Travel to sales meetings, medical offices, and meet patients face to face as necessary
Present quarterly to monthly case review sessions for others to learn from
Attend regional CMSA conference or national meetings related to all disease states we support

MYS Ctsm Kl-cadd Bsu-senior Case Manager Resume Examples & Samples

Conduct research for company information from both internal and external sources, documenting specifics required to satisfy regulations
Own the end to end KYC process from creation/renewal to approval of the e-CADD and supporting local country appendices
Liaising with KYC partners to resolve KYC issues
Initiate Customer Due diligence form (CADD) for the Global banking clients, complete all the relevant information on the CADDS either by researching through the internet sites,
Prepare management report/status report on AIU activities to Business groups
Retrieve records for surveillance, internal and external audit enquiries, and quarterly Risk Control Self-Assessment
Assist Management/Regional AIU teams in completing special projects

Senior Case Manager Resume Examples & Samples

Assists with day-to-day activities of the project including review incoming claims
Participates in weekly ITVERP meetings with OVC COR
Reviews, edits, and approves project-related correspondence before submission to the ITVERP COR
Drafts technical reports such as Reports to Congress and Annual Report for ICF PM review
Drafts policy memos as necessary
Drafts revisions/updates to ITVERP standardized forms/templates or memos as needed, and submits to ICF Project Manager review
Provides guidance to the case manager with claims processing
Works with the ITVERP case manager to responds to all data call requests
Interacts professionally with diverse government officials, including but not limited to, the Department of State, the Federal Bureau of Investigation, and the National Security Division within the Department of Justice
Bachelor’s degree in Social Work, Psychology, Sociology, Counseling, Mental Health, Anthropology, Education, or other Social Science related discipline required
5-9yrs of experience in related area
3-5years of government based, client, or customer facing experience in the social sciences field
Experience supervising staff
Experience interacting professionally with a wide variety of stakeholders
Experience drafting diverse documents (i.e. letters, reports, correspondence, and claim recommendations)
Ability to obtain a Department of Justice security clearance, which involves a criminal background and credit check
Previous experience with client management highly preferred
Experience working in a consulting environment and with government programs preferred
Demonstrate immaculate attention to detail
Ability to produce high quality work required
Ability to be flexible, multi-task, prioritize, detail-oriented, and manage multiple activities simultaneously in a fast-paced, changing environment
Experience working directly with victims of crime
Ability to speak another language fluently
Demonstrated commitment to client satisfaction
Demonstrated outstanding level of professionalism in providing administrative support, including ability to exercise good judgment, discretion, tact, and diplomacy
Ability to work with all levels of internal staff, as well as outside clients and vendors
Superior interpersonal skills including courtesy, professionalism, and a cooperative attitude

Senior Case Manager Resume Examples & Samples

Responsible for the acceptance, investigation, and timely resolution of complex complaints received from FOS and COSL
Ensure all departmental Service level agreements are met
Undertake any other task within the CRU assigned by the Department Head when assistance is necessary
Participate in improvement initiatives and make pro-active constructive improvement recommendations
HSC (or equivalent)
Ability to self manage

Senior Case Manager Resume Examples & Samples

Conduct member outreach calls by special assignment
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems if 10Mx1M
Previous experience in utilization management, case management, discharge planning and/or home health or rehab

Senior Case Manager Resume Examples & Samples

Works closely with patient/family to case manage all steps required to gain access to therapy
Responsible for maintaining case history for all assigned patients in the CRM system
Professionally field incoming telephone calls while making a positive impression

Senior Case Manager Resume Examples & Samples

Provide support, guidance and lead team members
Point of escalation for Team
Communicate and coordinate with senior management of ICG EMEA from coverage, compliance, implementations, risk, and operations in various products
Assist with Process Design and management for department
Maintain a workforce with capability to execute flawlessly
Extensive years of experience in banking or finance
Extensive years of people management experience
Experience in control/risk or Compliance (AML/KYC) function (an advantage)
Excellent communication skills – ability to communicate at all levels within the organisation
Excellent people management experience
Proficient use of Microsoft Applications ( Word, Excel, Access, PowerPoint, Visio, Project )

Senior Case Manager Resume Examples & Samples

Case management of a block of disability claims
Request medical and financial information as appropriate for the condition claimed
Review the information once returned in order to consider the next steps to be taken on the file
Confer with in-house medical consultants for advice on medical conditions
Confer with in-house financial consultants for advice on calculating pre disability income
Calculate loss of income for disability claims and make appropriate payments
Perform an annual reconciliation for each claim to ensure that the previous year was paid appropriately
Provide explanations for claims actions both in writing and on the telephone
Handle inquiries from both member, plan administrator, and call centre
Participate in projects that impact the OMA or new business
Extensive disability case management experience, minimum 5 years, including management of complex critical Illness claims
Extensive customer service experience, including good negotiating skills
Solid knowledge of medical terminology together with significant understanding of how various medical conditions affect ability to work
Must have strong organizational, interpersonal, motivational and communication skills to manage this specialized role
Must have good understanding of contract language and policy
Solid understanding of related legislation and/or recent jurisprudence
Communication (includes ability to translate technical topics into a clear communication for a client, report writing, policy writing, documentation, presentations)
Business and professional integrity and ethics
Post-secondary education and/or extensive equivalent work experience
5+ years related experience in insurance underwriting and/or claims adjudication
An understanding of complex financial statements related to medical practitioner operations

Senior Case Manager Resume Examples & Samples

Work with customers to access government-sponsored programs (TANF) and receive program services
Interact with program participants on a regular, daily basis, and educate customers on program services and requirements
Exhibit significant program knowledge and assist with all phases of the Employment First Program
Work with program participants to assess and remove barriers to employment and monitor program participant progress
Complete daily, weekly and monthly reports
Provide a high level of customer service to program participants and meet multiple deadlines
Work simultaneously in multiple databases and applications
Perform lead duties as required
Four (4) years of customer service, sales, or outreach experience required
Bachelor's degree in Human Services or business-related field preferred
Ability to communicate effectively and professionally; verbally and in writing, to all segments of the population
Experience with the Chamber of Commerce and/or other community groups preferred

Senior Case Manager Resume Examples & Samples

Participates in handling the grievances, appeals/ denials process. Ensures appeals are processed in accordance with regulations, compliance standards and policies and procedures. Meets timeframes for performance while balancing the need to produce high quality work related to complex and sensitive member issues
Investigates all issues, including collection of appropriate data, preparation and presentation of documents to decision makers. Informs members or their authorized representatives, physicians and other stakeholders of Health Plan's determinations
Collaborates with internal staff, other MS Departments, managers and physicians to seek resolution on issues and cases affecting member while ensuring compliance, documentation and enhancing members' experience. Ensures integrity of departmental database by thorough, timely and accurate entry
Mentors others in preparation for positions of increased responsibility. Participates in departmental meetings, trainings and audits as requested. Answer questions and manages members on existing / open cases
Minimum six (6) years of customer service experience OR minimum six (6) years of experience working in a complex health care environment
Minimum one (1) year of experience handling complaints and issue resolutions, and interpreting health plan coverage and contractual agreements

Senior Case Manager Resume Examples & Samples

Active RN license in CO and NM free of restrictions
At least 2 - 3 years prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
Previous experience in case management a plus
Prior experience working in an inpatient or outpatient setting

Senior Case Manager Resume Examples & Samples

Managing a portfolio of claims from 0-78 weeks, through effective case management, communication and influencing strategies to deliver comprehensive support, guidance and client service to injured workers and employers
Providing Workers’ Compensation claims and return to work advice to all stakeholders and participate in claims reviews
Working in conjunction with treating health practitioners, providers and employers to drive injured workers’ return to work
Coordinating and overseeing progress with rehabilitation and return to work to achieve quality outcomes
Reviewing the entitlement of injured workers in line with the Act and the claims manual

Senior Case Manager Resume Examples & Samples

Participate in managing the organization's Grievance, Appeal and External Review process
Accountable for investigation and response of all issues, including collection of appropriate data, preparation and presentation of documents to decision makers
Responsible for responding to members or their authorized representatives, physicians and other stakeholders regarding the Health Plan's determination within regulatory timeframes while meeting quality and customer focused standards
Communicate with a diverse set of internal and external clientele to achieve excellent results in the area of case handling, compliance, documentation and enhancement of the member experience
Partner with and outreach to internal staff, other MS Departments, managers and physicians to resolve issues as quickly as possible
Ensures appeals are processed and effectuated in accordance with regulations, compliance standards and policies and procedures
Meets timeframes for performance while balancing the need to produce high quality work related to complex and sensitive member issues
Ensures integrity of departmental database by thorough, timely and accurate entry
Mentors others in preparation for positions of increased responsibility
Participates in departmental meetings, trainings and audits as requested Answer questions from members/advocates on existing/open cases Escalates issues to management as appropriate
Ensures regulatory compliance with work product
Minimum three (3) years of experience in a service related industry
Three (3) years of experience in a complex health care environment
Knowledge of member grievance and appeals processing preferred
Competent working knowledge of Kaiser Permanente Health Plan benefit plan/contracts/systems strongly preferred
Strong working knowledge of federal and state regulations, laws and accreditation standards related to health care and managed care organizations

Senior Case Manager Resume Examples & Samples

Provide extensive escalated customer service interaction as needed
Provide project reporting, including staffing and financial status, project performance and risk analysis and mitigation
Analyzes, defines, and documents requirements for data workflow, logical processes, interfaces with other systems, internal and external checks and controls, and output
Prepares documents and summaries for submission to clients
Creates and delivers vital presentation to clients and internal staff
Develops needs for existing clients and develops ideas for new business
Resolves complex issues in creative and effective ways
Plans and manages schedules and budgets for a project
Prepares papers and presentations for external publications
Works with federal and commercial clients as assigned
Ability to manage staff and business process that require high level of productivity in short period of time

Senior Case Manager Resume Examples & Samples

Manages the Care Coordination process while balancing the needs of individual patients with the business realities and necessities of Genzyme and US Genetics
Assists in obtaining insurance approval for enzyme replacement therapy, and proactively plans for maintenance of coverage by working with the patients and their family, healthcare providers, insurance companies, specialty pharmacies, and Genzyme Colleagues
Establishes and maintains professional and effective relationships with all internal and external customers including but not limited to care coordination colleagues, medical, sales, corporate accounts, Patient Advocacy, insurance company case managers, specialty pharmacies, home health agencies, infusion site staff and office coordinators
Raises own performance expectations and goals to support entrepreneurial approach to the business
Demonstrates understanding of Genzyme’s business model, and their role in commercializing the business
Is proficient in the use of Sales Logix and in producing data specific reports upon request

Senior Case Manager Resume Examples & Samples

Manage the assigned loan portfolio ensuring all relevant Capita, Client and legislative policies and procedures are adhered to. However, assignment of work may not always be on a case ownership basis it will be driven by the Senior Manager Residential Mortgage / ASU and will vary over time depending on overall portfolio position
Assess the current position on each account in your portfolio/ workload in relation to balance, arrears, payment history and customer engagement to date. You will then actively engage via phone, letter and personal meetings with customers primarily to ensure all relevant information is collated, arrears are collected and accounts are regularized
Individual activity on accounts should be in line with divisional process, systems and procedures and overall compliance with CPC and CCMA regulations
For customers who find themselves in a position where they cannot repay or regularize their accounts you will collate all relevant financial and personal data via SFS with a view to determining if accounts are sustainable and what range of forbearance or other options are available to the client
Assess options available and make written recommendations to internal credit team of most appropriate course of action for individual clients
Engage with internal legal and enforcement teams in cases where the customer is not cooperating and where legal recovery is most appropriate
Maintain relationships with third parties including MABS and customer debt mediators
Work to ensure achievement of individual and team key contact and collections targets and KPIs
Ensure the timely and accurate escalation of any internal or external issues
Ensure all engagement with customers is accurately recorded and the timing of activity / contact is in line with regulatory requirements, company policy and procedures, and customer expectations
If / when necessary provide information to support decisions in relation to customer appeals
Where applicable, co-ordinate all regular management information and ad hoc report requests for the team to the highest standard
Where appropriate, provide mentoring support to other team members to promote staff development and maximise team performance
Maintain Borrower information files and accurately input information onto various systems
Assist the management team with new business development where required
Ensure timely delivery of M.I
Ad hoc duties will include general administration on customer accounts and involvement in internal projects / change initiatives
QFA / APA required
Up to date knowledge of applicable regulatory code and application of MARP strategies
At least 3 years’ experience of lending and / or recoveries in residential and commercial loans essential
Experience of working in a client facing role and of negotiating with distressed borrowers and their advisors, coupled with a strong background in managing complex problem cases
Strong financial analysis skills with a proven ability to review, understand and interpret financial accounts, management accounts and budgets
Experience of and ability to review loan and security documentation ensuring that legal advice is taken when required
Experience in drafting strategy and credit papers
Working knowledge of local tax, legal and accounting regulations
Knowledge and experience of managing and collection on delinquent connections / loans
Experience in managing cases through the insolvency process; incorporating liquidation, receivership and examinership would be a distinct advantage
Ability to work independently and as part of a team, demonstrating strong communication, influencing and negotiating skills along with ability to organise and meet tight deadlines are essential skills
Proficiency in the use of Microsoft Office suite- particularly Excel
Candidates will be required to comply with the Central Bank's Fitness and Probity Standards including the company's due diligence process in assessing their fitness and probity under the areas of (1) Competent and Capable, (2) Honest, Ethical and Integrity and (3) Financial Soundness

Senior Case Manager Resume Examples & Samples

Early contact with all parties leading to earlier identification of needs
Liaison with all parties including employer, injured workers, nominated treating doctors and external service providers
Make decisions regarding initial and ongoing liability
Determination of Initial and ongoing wage payments
Manage daily workflow in order to maintain client service standards
Interpret legislation and apply accurately
Interpret and apply the Claims Manual and Claims Estimating Guidelines
Timely decisions on various treatment and service requests
Develop strong working relationships with team members, Injured Workers, clients and external providers
Proven experience in QLD Workers’ Compensation,
Tertiary qualifications in an appropriate discipline and/or demonstrated experience in a similar role
Strong customer service ethic
PC literate – Claims System Database/s and Microsoft Office
Tertiary qualifications in an appropriate discipline preferred

Senior Case Manager Resume Examples & Samples

The Senior Case Manager will take in new orders from clients and send instructions to research teams on conducting due diligence projects
The manager will oversee and take ownership over the research projects, ensuring reports are completed to client expectations
The Case Manager will also conduct open source research and draft complex reports. In addition, the role requires responsibility for maintaining regular contact with clients for relationship-building, assistance in business development, and ensuring that due diligence projects stay up-to-date with changing client needs
Reporting to the Head of EMEA Case Management this position is based in Dubai
Key tasks will include
Conduct day-to-day management and support for clients including assignment intake, planning and supervision of cases
Provide quality control and ensure reports are completed to client specification and on deadline
Conduct open source due diligence research and write complex reports (as required)
Identify areas of opportunity for business development within existing clients and prospects
Identify and develop sources of information in locations where research is required
Act as subject-matter expert when managing client accounts and supporting business development efforts
Assist with case management and client liaison in other areas
Developing sources of information in locations where research is required
Liaising with subcontractors and vendors
Negotiating best pricing for services and managing costs
Providing product training and support to new sales and support staff
Support business development in the Middle East and North Africa regions

Basu Cadd-senior Case Manager Resume Examples & Samples

Perform Checker review of High Risk KYC Records
Returns the KYC Records to BSU Case Manager if not complete
Approves if complete (then sent to next approver)
Support Operations Head, Team Lead, and case managers in the completion of KYC Records
Point of escalation for Case Managers, Relationship Managers team and Compliance within cluster / region
Achieve operational goals set, and deliver against agreed targets in terms of quality, productivity and Customer Service
Conduct the performance appraisals process for junior staff and assess their developmental needs
Develop coverage/succession plan for out of office/ holidays and vacation scenarios
Responsible for the execution/completion of KYC Records assigned to the pod and quality control of the completed Records
Responsible for checking all KYC Records within team, and capturing rejection reasons per record checked
Meet Case Managers on daily basis to discuss WIP KYC Records and for provide feedback to them based on records checked
Mentor and coach Case Managers & New SCMs on an ongoing basis
Acts as expediter for chasing up 1st level escalations within the BSU organization
Ensure that relationship/coverage team gets the expected service within the agreed timelines and facilitate calls where deemed necessary
Act as the country coordinator (or participate actively when the CM is the country coordinator – a) coordinate periodic country calls; b) liaise with compliance; c) be the primary contact for country management for KYC related matters
Monitor workflow database daily and ensure that various KYC Records activities are getting competed in-time and as expected
Resolve any issues in performance or in quality of KYC Records and escalate to Team Lead / Operations Head wherever necessary
Proactively identifies and resolves any other execution risks and issues, escalating Issues to RM Supervisor, Compliance, Operations Head etc. to ensure CADDs progress
Responsible for processing KYC Records population, preferably complex cases that need higher level of experience/attention to detail
Conduct calibration sessions to standardize knowledge across SCMs
Review/implement feedback from Compliance and QA (as applicable) to ensure continuous improvements
Monitor their pipeline of work daily (e.g. coming due) and ensure actioned as per agreed timelines Ensure data quality in the BSU/KWT with periodic checks
Provide support and cover to the SCMs within BSU on generic activities such as Checker Hub
Experience: Up to 3 years in Banking / KYC related operations
Skills: Excellent written and verbal communication skills – ability to communicate at all levels

Senior Case Manager Resume Examples & Samples

Working in conjunction with treating health practitioners, providers, and employers to review and monitor effective medical and like entitlements in line with legislation and relevant acts
Providing effective and efficient claims administration to ensure that injured workers receive fair and accurate compensation in accordance with relevant legislation
Providing a high quality and empathetic customer service to internal and external stakeholders
Complying with the relevant Acts and other relevant Legislative requirements
A strong sense of accountability with the ability to follow through on tasks
Demonstrated ability working as part of a team
Strong interpersonal skills with the ability to build relationships
A proven track record in delivering on customers’ needs/requirements with the ability to empathise
Strong organizational and time management capability
A sound level of attention to detail

MYS Ctsm Kl-senior Case Manager Resume Examples & Samples

Lead a team of up to 6 Case Managers
Manage relationships with Relationship Management teams and Compliance for each country supported by the department
Work with Section Manager on goal setting, performance management planning/implementation and one to ones
Assist relationship and coverage teams globally in completion of the KYC Record
Perform the checking procedure and ensure quality and coaching needs are identified and met on the team
Oversight for Adherence with Citi and regulatory policies and procedures as well as housekeeping standards, team controls and processes
Management of ad-hoc departmental projects as assigned
Work with Section Manager to develop team members in line with versatility matrix and team needs
2-5 years’ experience in banking or finance
Proficient use of Microsoft Applications (Word, Excel, Access, PowerPoint, Visio, Project)

Icg-kyc-senior Case Manager Resume Examples & Samples

Defines and coordinates delivery of other AML commitments as they arise
The CitiKYC In-Process Checker will serve within the ICG KYC Quality Assurance Review Team. The team is tasked with ensuring high quality within KYC records, focusing on accuracy, completeness, and consistency of KYC records and in adherence to KYC policies
The job expectation is that the new hire will, through training and on-the-job learning, develop a thorough understanding of KYC requirements, and apply that knowledge during the review process. Findings are expected to be fed back to users to enhance the quality of the record and identify root causes to avoid future findings
The objective is to improve the quality of the KYC Records
Conduct end to end in-process reviews of KYC records in-country/-region
Report findings on a daily basis to ensure records are updated and root cause cleaned up/identified and addressed
Assist in root cause analysis by identifying & analyzing areas of common defect/issues/themes
Assist with department projects/initiatives as requested
Ensure completeness and accuracy of KYC records
Effective and close communication with KYC Owners, Makers, Compliance to improve KYC record quality
Work with colleagues within the Business Support Unit (BSU) and AML Compliance to resolve KYC issues
Participate in ad hoc projects related to quality improvements
A proven track record with at least 3+ years of relevant KYC/AML experience (could be one of the following: Quality Assurance, Client Onboarding, Compliance, Audit and Regulatory)
Experience in Financial Services institutions a plus
Experience and knowledge of AML and KYC compliance objectives and regulatory requirements and objectives
Strong analytical and time management skills, excellent attention to details
Comfort with technology including Excel and web-based systems
Compliance, Audit and Regulatory experience desirable
Strong Operations experience desirable
Global experience would be beneficial

Senior Case Manager Resume Examples & Samples

Manage relationships with Relationship Management teams and Compliance for each country supported by Department
Assist relationship and coverage teams globally in completion of the KYC for ICG Clients
Oversight for Adherence with Citi and regulatory policies and procedures as well as housekeeping standards, team controls & processes
Management of adhoc departmental projects as assigned
Work with RUK BSU Hub Manager to develop team members in line with versatility matrix & team needs
Manage flow of CitiKYC to adhere to internal SLAs
Assist in Departmental reviews as appropriate (RCSA , CitiKYC Peer reviews etc…)
2 – 3 years’ experience in banking or finance
University degree in Business/Finance, Math, Economics, or Law
Good knowledge of English Language
Accuracy and strong attention to detail

Senior Case Manager for Student Life Resume Examples & Samples

Licensed or license eligible as counselor, social worker, or psychologist in Texas
Experience working with individuals within a higher education setting and/or community setting
Demonstrated ability to work with diverse constituencies both on and off camps
Ability to multi-task and work cooperatively with others
Strong oral and written communication and interpersonal skills
Demonstrated multicultural competence in mental health service provision
All employees are expected to fully support Baylor’s mission to educate men and women for worldwide leadership and service by integrating academic excellence and Christian commitment within a caring community. All employees of Baylor University are expected to fully support and contribute to the university’s mission
Crisis intervention experience
Demonstrated expertise in clinical case management
Ability to deal with crisis situations
Knowledge of local community mental health resources
Experience our great dining facilities and enjoy an employee discount
Experience Baylor through many more wonderful events and programs that take place on campus each year
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Senior Case Manager Resume Examples & Samples

Planning and Implementation. Develops and implements action-oriented and time specific case management plans by determining and documenting specific objectives, goals, and actions designed to meet the client’s health and human service needs identified through the assessment process
Coordination.Organizes, secures, integrates, modifies, and documents the resources necessary to accomplish the goals set forth in the case management plan
Monitoring and Evaluation. Gathers information and documentation from all relevant sources regarding the case management plan’s activities and/or services to determine the plan’s effectiveness in reaching desired outcomes and goals. Modifies or changes the case management plan, as needed
Outcomes. Measures and analyzes the interventions to determine the outcomes of case management involvement, e.g. clinical, financial, variance, quality/quality of life, client satisfaction
As Needed. Performs other duties as needed to successfully fulfill the function of the position, including but not limited to orienting and educating consumers, maintaining records of service delivery, serving as liaison between the program and other agencies, conducting quality improvement audits, and report preparation
Knowledge of federal and state laws particularly patient confidentiality
Knowledge of case management fundamentals and the technical/ procedural aspects of case management
Ability to resolve moderately complex issues applying judgment, critical thinking and problem solving skills to determine a proper course of action
Must have a high level of organizational skills
Ability to keep accurate, detailed records
Ability to handle stressful situations, different situations and circumstances, and complete paperwork and projects in a timely manner
Ability to set priorities and manage obstacles while maintaining focus on goals
Ability to build and maintain professional relationships with clients, colleagues, and other agencies while following ethical standards of practice
Must be self-motivated to achieve results, be flexible when changes are necessary, and respond to feedback in a positive manner

Senior Case Manager Resume Examples & Samples

Make soundly based decisions for initial liability determination and subsequent reviews
PIAWE calculation
Assessment of Weekly Entitlements
Assessment of Work Capacity and Making Working Capacity Decisions
Interpret and accurately apply relevant legislation and regulatory guidelines accurately
Interpret and apply the Claims Estimating Guidelines
Developing, facilitating and implementing outcome based claims
Develop strong working relationships with Team Members, Injured Workers, clients and external providers
Proven experience in NSW Workers’ Compensation,
Strong Time management and organisational skills
Experience in Self-Insurance Workers Compensation Claims is highly desired

Senior Case Manager Inpatient Services Resume Examples & Samples

Collaborates effectively with integrated care team (ICT) to establish an individualized plan of care for members. The interdisciplinary care team develops interventions to assist the member in meeting short and long term plan of care goals
Serves as the clinical liaison with hospital, clinical and administrative staff as well as provides expertise for clinical authorizations for inpatient care. based on utilized evidenced-based criteria
Performs concurrent and retrospective onsite or telephonic clinical reviews at the designated network or out of network facilities. Documents medical necessity and appropriate level of care utilizing national recognized clinical guidelines
Provide assessments of physical, psycho-social and transition needs in settings not limited to the PCP office, hospital, or member’s home
Develops interventions and processes to assist the member in meeting short and long term plan of care goals
Manages assigned case load in an efficient and effective manner utilizing time management skills to facilitate the total work process directly monitoring assigned members
Provides constructive information to minimize problems and increase customer satisfaction
Demonstrates knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning activities
Confers with physician advisors on a regular basis regarding inpatient cases and participates in department case rounds. Plans member transitions, with providers, patient and family
Enters timely and accurate data into designated care management applications as needed to communicate patient needs and maintains audit scores of 90% or better on a monthly / quarterly basis
Adheres to organizational and departmental policies and procedures and credentialed compliance
Attends and Participates in integrated care team meetings as directed
Problem solving by gathering and / or reviewing facts and selecting the best solution from identified alternatives. Decision-making is usually based on prior practice or policy, with some interpretation. Must apply individual reasoning to the solution of problems, devising or modifying processes and writing procedures as necessary
With the assistance of the Managed Care / UM teams, guides physicians in their awareness of preferred contracts and providers and facilities
Refers cases to Medical Director as appropriate for review or requests not meeting criteria or for complex case situations
Serves as a subject matter expert and preceptor to Case Manager I and II staff
Promotes a team environment leading by example and acting as a team lead as assigned by manager. Encourages teammates to participate in company initiatives, goals and directives
Bachelor’s degree in Nursing, or Associate’s degree in Nursing and Bachelor’s degree in related field, or Associate’s degree in Nursing combined with 4 or more years of experience
Seven or more years of diverse clinical experience in caring for the acutely ill patients with multiple disease conditions
Four or more years of managed care and / or case management experience
Ability to read, analyze and interpret information in medical records, health plan documents and financial reports
Possess planning, organizing, conflict resolution, negotiating and interpersonal skills
Independent problem identification / resolution and decision making skills

Senior Case Manager Resume Examples & Samples

Providing a cost effective, professional and customer focused workers compensation claims service through managing claims, identification of claims with escalating risk, management of liabilities, delivery of high quality service levels and a commitment to learning and development
Working in conjunction with treaters, providers and employers to return injured workers to work
Achieving remuneration targets as described by the Worksafe contract
Implementing medical and like cost management strategies on claims
Working closely with your Injury Management Advisor and Technical Manager to produce a return to work or review of entitlement
Attending Case Conferences
Working in conjunction with treaters, providers and employers to monitor effective medical and like programs for injured workers
Claims Management/ Workers Compensation experience
Knowledge of general business and administrative practices
Tertiary qualifications in an appropriate discipline and/or Industry specific qualifications will be held in high regard

Senior Case Manager Resume Examples & Samples

Proficient with Microsoft Office including Word, Outlook and Excel
Valid driver’s license and/or dependable transportation necessary (variable by region)
Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

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