Medical Case Manager - Remote

Overview

The Medical Case Manager ensures that members with complex medical and psychosocial needs have access to high-quality, cost-effective health care while collaborating with various healthcare providers to facilitate member care.

In Short

• Assists in holistic assessment and planning for healthcare services.
• Advocates for appropriate care plans using clinical judgment.
• Communicates effectively with members and healthcare teams.
• Maintains knowledge of medical terminology and disease states.
• Collaborates with primary care physicians and specialists.
• Develops individualized plans of care for members.
• Participates in interdisciplinary meetings for care coordination.
• Educates members on their health conditions and care plans.
• Maintains knowledge of community resources for members.
• Attends required meetings and continuing education forums.

Requirements

• Bachelor’s degree in nursing or social work, or equivalent experience.
• 3-5 years of experience in Acute or Managed Care.
• Experience with Medicaid or Medicare populations.
• Bilingual in English and Spanish preferred.
• Case Management Certification is required.
• Strong communication and collaboration skills.
• Ability to work independently and as part of a team.
• Knowledge of available healthcare resources.
• Experience with high-risk populations is a plus.
• Licenses and certifications in relevant fields are required.

Benefits

• Competitive salary based on experience.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Flexible work arrangements.
• Access to community resources.
• Continuing education opportunities.
• Team collaboration and support.
• Employee assistance programs.
• Commitment to diversity and inclusion.