Care Management Clinician

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🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $71k - $106.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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PacificSource Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

⚕️ Healthcare Insurance

💸 Finance

🧘 Wellness

Healthcare Insurance • Finance • Wellness

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation • Collect and assess patient information pertinent to patient’s history, condition, and functional abilities • Develop a comprehensive, individualized care management plan • Link clients with appropriate providers and resources throughout the continuum of health and human services and care settings • Ensure that the care provided is safe, effective, client-centered, timely, efficient, and equitable • Interact with other PacificSource personnel to assure quality customer service is provided • Act as an internal resource by answering questions requiring medical or contract interpretation

🎯 Requirements

• Minimum of three (3) years of clinical experience, including case management • Insurance industry experience preferred • 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) 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 • Ability to deal effectively with people who have various health issues and concerns • Knowledge and understanding of contractual benefits and options available outside contractual benefits • Ability to use computerized systems for data recording and retrieval • Assures patient confidentiality, privacy, and health records security.

🏖️ Benefits

• Flexible telecommute policy • Medical, vision, and dental insurance • Incentive program • Paid time off and holidays • 401(k) plan • Volunteer opportunities • Tuition reimbursement and training • Life insurance • Options such as a flexible spending account