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 healthcare through assessment, coordination, and advocacy.

In Short

• Facilitate access to healthcare services for members with complex needs.
• Advocate for appropriate care plans using clinical judgment.
• Communicate effectively with various healthcare professionals.
• Conduct holistic assessments and develop individualized care plans.
• Maintain knowledge of medical terminology and disease states.
• Collaborate with primary care physicians and healthcare providers.
• Monitor member progress and adjust care plans as needed.
• Coordinate with community organizations for additional resources.
• Participate in interdisciplinary team meetings for care coordination.
• Attend continuing education to enhance clinical skills.

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.
• Case Management Certification preferred.
• Bilingual English/Spanish skills preferred.
• Licensure as a social worker or registered nurse required.
• Ability to work independently and collaboratively.
• Strong communication and problem-solving skills.
• Knowledge of community resources for healthcare support.
• Commitment to ethical and legal standards in healthcare.

Benefits

• Competitive salary range of $57,700 - $107,800.
• Opportunities for professional development and continuing education.
• Access to a broad spectrum of health-related needs and services.
• Supportive work environment with a focus on team collaboration.
• Flexible working arrangements in a telecommute setting.