Case Management Specialist
Core
Telephonic care coordinator for Special Needs Plan members with social determinants of health and stable conditions, focusing on care planning, resource connection, and closing gaps in preventative care.
Role type
Telephonic Case Management Specialist
Builds
Individualized care plans and member engagement strategies for Medicare/Medicaid members
Domain
Healthcare / Managed Care (Medicare/Medicaid)
Deliverable
client delivery
Required skills
Telephonic engagement, care planning, resource identification, regulatory compliance, healthcare technology navigation, documentation
Preferred skills
Medicare/Medicaid care management experience, SDoH/chronic condition/behavioral health experience, health assessment facilitation, bilingual (English-Spanish)
Technologies
Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams), Electronic Health Record systems
Responsibilities
Conduct telephonic member outreach and engagement; Develop individualized care plans; Connect members with community resources and health plan benefits; Maintain documentation in electronic health records; Collaborate with interdisciplinary care teams including Registered Nurses; Meet performance metrics and regulatory requirements
Seniority
Individual Contributor, entry-to-mid level