Care Management Clinician

Job not on LinkedIn

🔥 18 hours ago

⚔️ Virginia – Remote

⚔️ Virginia – 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 across health and human services and care settings • Coordinate communication among clients, payers, primary care providers and other service professionals • Maintain client privacy, confidentiality, health and safety in accordance with ethical, legal, accreditation, certification and regulatory standards • Answer medical or contract interpretation questions referred from other departments, physicians and providers • Assist employers and agents with healthcare resource and procedure questions • Use evidence-based tools and lean methodologies for continuous improvement • Meet department and company performance and attendance expectations • Follow PacificSource privacy policy and HIPAA requirements • Perform other duties as assigned • Work in a general office setting and 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) as 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 • Ability to use computerized systems for data recording and retrieval • Ability to work independently with minimal supervision • Ability to read and comprehend both written and spoken English • Communicate clearly and effectively • Insurance industry experience preferred