Case Manager

Overview

Join our dynamic healthcare team as a Case Manager and play a vital role in coordinating patient care, optimizing health outcomes, and ensuring seamless communication across multidisciplinary teams. In this energetic and impactful role, you will leverage your clinical expertise and social services knowledge to support patients through complex medical journeys. Your dedication will help improve discharge planning, utilization management, and patient satisfaction while working within a collaborative environment committed to excellence.

Responsibilities

• Conduct comprehensive patient assessments to determine individual needs across acute care, hospice, behavioral health, and social services settings.
• Coordinate interdisciplinary care plans, ensuring timely and appropriate discharge planning and resource allocation.
• Collaborate with hospital staff, physicians, social workers, and external providers to facilitate smooth transitions of care.
• Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems to document case progress, update patient information, and ensure compliance with HIPAA regulations.
• Perform utilization review and management activities, including CPT coding, ICD-9/10 coding, and authorization processes for insurance purposes.
• Communicate effectively with patients and their families, providing education on health insurance options, medical terminology, and available social services.
• Maintain detailed records of patient interactions, service plans, and compliance documentation to support quality assurance initiatives.

Qualifications

• Proven experience in critical care environments such as ICU or Level I/II trauma centers; hospital medicine or emergency medicine experience highly preferred.
• Strong background in nursing or social work with familiarity in behavioral health, pediatrics, or managed care settings.
• Knowledge of medical coding systems including CPT, ICD-9/10, ICD coding; experience with utilization review or utilization management is a plus.
• Proficiency in Microsoft Office suite along with EMR/EHR systems; ability to navigate complex documentation platforms efficiently.
• Excellent client communication skills with the ability to work effectively with individuals from diverse cultural backgrounds.
• Familiarity with HIPAA regulations and health insurance processes to ensure confidentiality and compliance.
• Bilingual abilities are desirable but not mandatory; a compassionate approach combined with critical thinking skills is essential for success in this role.

Pay: From $25.00 per hour

Expected hours: 10.0 – 20.0 per week

Work Location: In person