Care Management Clinician

Job not on LinkedIn

🔥 17 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $71k - $106.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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PACIFICSOURCE

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Facilitate client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation • Collect and assess patient information to develop comprehensive, individualized care management plans • Promote appropriate utilization and cost-effective care and services • Link clients with appropriate providers and resources throughout health and human services and care settings • Ensure care is safe, effective, client-centered, timely, efficient, and equitable • Communicate with clients, payers, primary care providers, and other service delivery professionals • Maintain client privacy, confidentiality, health, and safety through advocacy and adherence to applicable standards and regulations • Provide quality customer service to PacificSource personnel • Serve as an internal resource for medical or contract interpretation questions • Assist employers and agents with healthcare resource and procedure questions • Use effective written and verbal communication • Utilize and promote evidence-based tools • Utilize lean methodologies for continuous improvement • Meet department and company performance and attendance expectations • Follow PacificSource privacy policy and HIPAA laws and regulations • Perform other duties as assigned

🎯 Requirements

• Minimum of three (3) years of clinical experience, including case management • Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required • Certified Case Manager Certification (CCM) accredited by CCMC required at time of hire or within two years of hire date • Knowledge of health insurance and state mandated benefits • Experience and expertise in case management practice, including advocacy, assessment, planning, communication, education, resource management, and service facilitation • Knowledge of contractual benefits and options outside contractual benefits • Knowledge of community services, providers, vendors, and facilities • Ability to use computerized systems for data recording and retrieval • Ability to maintain patient confidentiality, privacy, and health records security • Ability to establish and maintain relationships with community services and providers • Ability to maintain current clinical knowledge base and certification • Ability to work independently with minimal supervision • Ability to read and comprehend written and spoken English • Clear and effective communication skills • Insurance industry experience preferred • Accountability, collaboration, flexibility, active listening, organizational skills, problem solving, and teamwork

🏖️ Benefits

• Work-from-home location (WFH: FL) • Travel required approximately 5% of the time • Equal opportunity employment • Employer-supported diversity, equity, inclusion, and social justice efforts