Medical Case Manager - Remote

Overview

The Medical Case Manager plays a crucial role in coordinating care for members with complex medical and social needs, ensuring they receive timely access to appropriate services.

In Short

• Responsible for triaging member assignments based on clinical assessments.
• Facilitates holistic assessments and care planning.
• Advocates for optimal care plans through collaboration.
• Communicates effectively with various stakeholders.
• Maintains knowledge of medical terminology and conditions.
• Develops individualized care plans for members.
• Continuously monitors member progress and adjusts care plans.
• Coordinates with community resources for additional support.
• Participates in interdisciplinary meetings for care coordination.
• Maintains compliance with regulatory guidelines and documentation.

Requirements

• Bachelor’s degree in nursing or related field.
• 3-5 years of experience in Acute or Managed Care.
• Case Management Certification preferred.
• Proficiency in Electronic Health Records (EHR).
• Strong critical thinking and problem-solving skills.
• Licensed Social Worker (LSW) or equivalent required.
• Experience with Medicaid and Medicare populations.
• Ability to work independently and as part of a team.
• Effective communication skills.
• Knowledge of community resources and healthcare systems.

Benefits

• Competitive salary with a range from $57,700 to $107,800.
• Opportunities for continuing education.
• Supportive work environment with interdisciplinary collaboration.
• Access to a broad spectrum of health-related resources.
• Potential for career advancement within the organization.