Case Manager

Overview

• Provide comprehensive case management services addressing medical, social, psychological, physical, and spiritual needs of members.
• Collaborate with primary care providers, caregivers, and interdisciplinary teams to develop and monitor care plans.
• Work in a hybrid environment with initial training in-office and transition to remote work.
• Opportunity to work with diverse populations, including bilingual Mandarin/Cantonese members.
• Contribute to a mission-driven organization focused on member well-being and care quality.
• Engage in monthly in-office meetings to enhance collaboration and professional development.
• Access to professional growth opportunities and potential sign-on bonuses for qualified candidates.
• Utilize advanced case management tools and processes to ensure compliance and efficiency.

Key Responsibilities & Duties

• Develop, implement, and monitor individualized care plans in collaboration with interdisciplinary teams.
• Provide case management services to members, addressing their comprehensive needs.
• Ensure compliance with federal and state managed care regulations and guidelines.
• Utilize InterQual and local Medicare coverage guidelines for effective case management.
• Maintain accurate documentation using Windows-based tools, Word, and Excel.
• Participate in monthly in-office meetings to foster collaboration and professional growth.
• Support bilingual members, particularly Mandarin/Cantonese speakers, with tailored services.
• Collaborate with supervisors and team members to enhance care management processes.

Job Requirements

• Master of Social Work degree required; LMSW or LCSW preferred for additional benefits.
• Minimum of 2 years of experience in case management or related field.
• Proficiency in Windows-based tools, Word, and Excel for documentation and reporting.
• Knowledge of federal and state managed care regulations and utilization management processes.
• Experience with InterQual and Medicare coverage guidelines preferred.
• Strong written and verbal communication skills essential for effective case management.
• Ability to work remotely with occasional in-office meetings and training sessions.
• Bilingual proficiency in Mandarin or Cantonese highly desirable.