Remote Clinical Case Manager

Job Summary

Supporting the Enhanced Care Advocate and ECM team, the full-time Remote Clinical Case Manager will manage case evaluations, develop care plans, and coordinate with members and vendors to optimize health outcomes.

Key responsibilities

• Review clinical data and develop strategic care plans for members with diverse health scenarios
• Coordinate implementation of care plans by collaborating with members, clients, and specialized vendor partners
• Document casework impacts and troubleshoot issues within Enhanced Case Management processes

Required qualifications

• Bachelor's degree or equivalent work experience required
• 2 years of experience with Group Health Insurance and Self-Funded Health Plans
• Experience in Medicare, Medicaid, Case Management, or prescription drug benefits preferred
• Proficiency in Microsoft Office Suite or related software
• Experience in a clinical or social work position is a plus