Case Manager

Job Title:

Case Manager Remote General Description

The Case Manager supports patients with complex, high-risk, or chronic health conditions through coordinated, patient-centered care. This role serves as a liaison between patients, providers, insurance partners, and community resources to ensure continuity of care, reduce barriers, and improve health outcomes. The Case Manager plays a critical role in care coordination, quality initiatives, and patient advocacy.

• Manage a caseload of high-risk and high-cost patients with complex medical and social needs
• Identify gaps in care, barriers to treatment adherence, and social determinants impacting health
• Conduct outreach and pre-visit planning to support care coordination and follow-up
• Collaborate with providers, care team members, and insurance partners to ensure continuity of care
• Upload required documentation into insurance portals to meet quality and compliance standards
• Create and analyze reports to monitor high-risk populations and care outcomes
• Coordinate referrals, authorizations, and access to community resources and support services
• Assist with clerical tasks including obtaining medical records, lab results, and consultation notes
• Participate in quality improvement initiatives and required meetings
• Maintain accurate documentation in the Electronic Health Record (EHR)
• Ensure confidentiality and HIPAA compliance at all times
• Represent the organization’s mission, values, and commitment to patient-centered care
• Perform other duties as assigned

• Basic understanding of medical terminology and healthcare documentation
• Strong organizational, analytical, and problem-solving skills
• Excellent communication skills, both verbal and written
• Ability to work effectively with diverse populations and interdisciplinary teams
• Demonstrates empathy, professionalism, and ethical conduct
• Strong customer service orientation with a patient-first mindset

• Licensed Practical Nurse (LPN) or Associate degree in nursing, social work, or a related field (required)
• Minimum of five (5) years of nursing or healthcare experience
• At least one (1) year of case management or related experience preferred
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Experience with HEDIS, quality metrics, or care coordination preferred
• Current Basic Life Support (BLS) certification preferred
• Ability to obtain and maintain EHR (e.g., Epic) certification and required compliance training

• Ability to sit for extended periods of time
• Ability to lift up to 20 lbs. regularly and 30–50 lbs. occasionally
• Regular exposure to computer screens
• Possible exposure to infectious or contagious diseases