Care Management Clinician

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Promote client wellness and independence through advocacy, assessment, planning, communication, education, resource management, and service facilitation.

• Gather and evaluate patient information to create comprehensive, personalized care management plans.

• Encourage the appropriate use of resources and cost-effective care and services.

• Connect clients with suitable providers and resources across health and human services as well as care environments.

• Ensure that care is safe, effective, client-centered, timely, efficient, and equitable.

• Communicate with clients, payers, primary care providers, and various service delivery professionals.

• Safeguard client privacy, confidentiality, health, and safety through advocacy and compliance with relevant standards and regulations.

• Collaborate with PacificSource personnel to deliver exceptional customer service.

• Address medical or contract interpretation inquiries directed from other departments, physicians, and providers.

• Assist employers and agents with questions regarding healthcare resources and procedures.

• Utilize and advocate for evidence-based tools.

• Implement lean methodologies for ongoing improvement.

• Meet departmental and company performance and attendance standards.

• Adhere to PacificSource privacy policy and HIPAA laws and regulations.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• A minimum of three (3) years of clinical experience, including case management.

• An active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential is required.

• Certification as a Certified Case Manager (CCM) accredited by CCMC is required at the time of hire or within two years of the hire date.

• Familiarity with health insurance and state-mandated benefits.

• Experience and proficiency in case management practices, encompassing advocacy, assessment, planning, communication, education, resource management, and service facilitation.

• Understanding of contractual benefits and options available outside of those benefits.

• Knowledge of community services, providers, vendors, and facilities.

• Competence in using computerized systems for data recording and retrieval.

• Ability to maintain the confidentiality, privacy, and security of patient health records.

• Capability to establish and sustain relationships with community services and providers.

• Commitment to maintaining an up-to-date clinical knowledge base and certification.

• Skill in working independently with minimal supervision.

• Proficiency in reading and comprehending both written and spoken English.

• Ability to communicate clearly and effectively.

• Physical ability to stoop, bend, sit and/or stand for extended periods, perform repetitive typing, sorting, and filing, as well as light lifting and carrying.

🏝️ Benefits

• Equal opportunity employment.

• Work in a general office environment equipped with ergonomically designed equipment.

• Travel approximately 5% of the time.