Care Management Clinician

Job not on LinkedIn

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – 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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 across health and human services and care settings • Ensure care is safe, effective, client-centered, timely, efficient and equitable • Communicate directly with clients, payers, primary care providers and other service professionals • Protect client privacy, confidentiality, health and safety through advocacy and adherence to ethical, legal, accreditation, certification and regulatory standards • Interact with PacificSource personnel to provide quality customer service • Answer medical or contract interpretation questions referred from other departments, physicians and providers • Assist employers and agents with healthcare resource and procedure questions • Practice 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 • Travel approximately 5% of the time

🎯 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 and understanding 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 both written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive motions, and lift and carry files and business materials • Insurance industry experience preferred

🏖️ Benefits

• Quality, affordable care access through PacificSource membership • Equal opportunity and diversity-focused work environment • Ergonomically configured equipment • At-will employment