Medical Case Manager - Pediatric - Remote

Overview

The Medical Case Manager - Pediatric position is a full-time role focused on ensuring that members with complex medical and psychosocial needs receive high-quality, cost-effective healthcare. The role involves assessment, planning, coordination, and advocacy for appropriate care plans.

In Short

• Full-time position with travel within Delaware.
• Responsible for coordinating healthcare access for members.
• Communicate effectively with various healthcare professionals.
• Develop individualized care plans based on member needs.
• Maintain knowledge of medical terminology and disease states.
• Collaborate with healthcare providers to enhance member care.
• Participate in interdisciplinary meetings for service coordination.
• Educate members on their health conditions and care plans.
• Work independently to resolve member issues.
• Attend continuing education to maintain professional licensure.

Requirements

• Bachelor's degree in nursing or social work, or relevant experience.
• 3-5 years of experience in Acute or Managed Care.
• Experience with Medicaid or Medicare populations.
• Preferred experience in Pediatric, Behavioral Health, and Physical Health.
• Bilingual English/Spanish is a plus.
• Case Management Certification is required.
• Licensure as a Social Worker, Registered Nurse, or Licensed Professional Counselor.
• Strong communication and collaboration skills.
• Ability to work in a team environment.
• Knowledge of community resources for member support.

Benefits

• Competitive salary range based on experience.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Flexible work arrangements.
• Access to continuing education resources.
• Employee wellness programs.
• Retirement savings plans.
• Paid time off and holidays.
• Employee assistance programs.