Medical Case Manager - Remote

Overview

The Medical Case Manager ensures that members with complex medical and psychosocial needs have access to quality healthcare while advocating for appropriate care plans.

In Short

• Assure access to high quality, cost-effective health care for members.
• Communicate effectively with internal and external contacts.
• Educate members on illness impacts and care plan adherence.
• Collaborate with various healthcare providers to coordinate care.
• Develop individualized care plans based on member needs.
• Monitor member progress and adjust care plans as needed.
• Maintain knowledge of community resources for members.
• Participate in interdisciplinary meetings to coordinate services.
• Attend continuing education to enhance clinical skills.
• Ensure compliance with regulatory guidelines and company policies.

Requirements

• Bachelor’s degree in nursing or social work or related field.
• 3-5 years of experience in Acute or Managed Care.
• Experience with Medicaid or Medicare populations preferred.
• CCM Certification preferred.
• Bilingual English/Spanish skills preferred.
• Required licenses: LSW, RN, LPC, or LBSW.

Benefits

• Competitive salary range based on experience.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Access to community resources for member support.