Medical Case Manager - Pennsylvania (Remote)

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Requirements:

• Minimum of a Bachelor's degree in nursing or Master’s degree in Social Work with 3 years of experience in Acute or Managed Care.
• Bachelor’s degree in Social Work with five years of experience in Acute or Managed Care.
• Preferred experience with high-risk pregnant women or chronic conditions.
• 3-5 years working with Medicaid or Medicare populations.
• Case Management Certification and bilingual skills in English/Spanish are a plus.

Responsibilities:

• Assure access to quality healthcare for members with complex needs.
• Assist in holistic assessment, planning, and coordination of care.
• Advocate for appropriate care plans and follow regulatory guidelines.
• Educate members on their health conditions to improve care plan adherence.
• Collaborate with various healthcare professionals to coordinate member care.
• Develop individualized care plans and continuously monitor member progress.