Care Management Clinician

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

📋 Description

• Support client wellness and independence by engaging in advocacy, assessment, planning, communication, education, resource management, and service facilitation.

• Gather and evaluate patient information regarding their history, condition, and functional abilities.

• Create detailed, personalized care management plans that encourage effective and economical care utilization.

• Connect clients with suitable providers and resources within health and human services and various care settings.

• Collaborate with clients, payers, primary care providers, and other service professionals.

• Ensure client privacy, confidentiality, health, and safety through advocacy and compliance with relevant standards and guidelines.

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

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

• Deliver high-quality customer service to PacificSource personnel and members.

• Employ and advocate for evidence-based tools.

• Apply lean methodologies for ongoing improvement.

• Meet performance and attendance standards.

• Execute additional responsibilities as assigned.

• Travel approximately 5% of the time.

⛳️ 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 necessary at the time of hire or within two years of the hire date.

• Familiarity with health insurance and state-mandated benefits.

• Proficient experience and skills in case management practices, including advocacy, assessment, planning, communication, education, resource management, and service facilitation.

• Capability to effectively interact with individuals facing various health issues and concerns.

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

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

• Proficient in using computerized systems for data entry and retrieval.

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

• Ability to build and sustain relationships with community services and providers.

• Commitment to keeping current clinical knowledge and certifications.

• Ability to work autonomously with minimal oversight.

• Meet departmental and company performance and attendance expectations.

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

• Proficient in reading and understanding written and spoken English.

• Ability to communicate effectively and clearly.

• Ability to stoop, bend, sit, and/or stand for extended periods, perform repetitive typing/sorting/filing tasks, and lift/carry files and business materials.

🏝️ Benefits

• Work from home arrangement based on location (WFH: TN).

• Equal opportunity employment.

• Opportunities for continuous improvement and professional development through evidence-based tools and lean methodologies.

• At-will employment.