Job Description

Job Title : Case Manager

Work Schedule : 100% Remote (PST Hours)

Languages : Fluency in Spanish is a plus but not required

License Required : RN, LPN or LCSW or APSW 

Experience : Experience with Geriatric Population (Preferred but not mandatory)

Summary :

As a Case Manager at the National Healthcare Organization, your role is to manage and coordinate healthcare services for our members, ensuring they achieve optimal clinical, financial, and quality of life outcomes. You will collaborate with members to create and implement comprehensive care plans, monitor their progress, and ensure that they receive cost-effective care in compliance with all state and federal regulations.

Essential Functions:

• Provides case management services to members with chronic or complex conditions, including:
  • Proactively identifies members eligible for case management services.
  • Conducts comprehensive assessments of member needs through information system, member, family/caregiver, hospital staff, physicians, and other providers.
  • Identifies, assesses, and manages members based on established criteria.
  • Develops and implements a collaborative case management plan with the member, caregiver, physician, and/or other healthcare professionals.
  • Performs ongoing monitoring of the plan to assess effectiveness.
  • Documents care plan progress in information system.
  • Evaluates the effectiveness of the care plan and makes appropriate modifications for optimal outcomes.
  • Measures intervention effectiveness to determine case management outcomes.
• Promotes integration of services, including behavioral health and long-term care, to enhance continuity of care for members.
• Conducts telephonic assessments as required.
• Maintains department productivity and quality measures.
• Manages and completes assigned work plan objectives and projects in a timely manner.
• Demonstrates dependability and reliability.
• Maintains effective team member relations.
• Adheres to all documentation guidelines.
• Attends regular staff meetings.
• Participates in Interdisciplinary Care Team (ICT) meetings.
• Assists in the orientation and mentoring of new team members as appropriate.
• Maintains professional relationships with the provider community and internal/external customers.
• Conducts self in a professional manner at all times.
• Maintains cooperative and effective workplace relationships, adhering to the company Code of Conduct.
• Participates in appropriate case management conferences for skill enhancement and professional growth.
• Complies with required workplace safety standards.

Required Education :

• Bachelor's degree in Nursing or a Master's degree in Social Work or Health Education. A combination of experience and education will be considered in lieu of a degree.

Required Experience :

• 1+ years of clinical case management experience.

Required Licensure/Certification :

• Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker (LCSW) or Advanced Practice Social Worker (APSW) in good standing.
• A combination of experience and education will be considered in lieu of LCSW or APSW.
• Valid driver's license with a good driving record and the ability to drive locally.

Additional Information :

This position offers high potential for a temp-to-perm opportunity. If you are a dedicated and skilled healthcare professional with a commitment to ensuring the well-being of our members, we encourage you to apply for this role with the National Healthcare Organization.

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