Care Management Clinician

PacificSource Health Plans

. Facilitate client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation .

Posted 9/15/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $70,950 - $106,425 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management, including the development of individualized care management plans and effective communication with clients and healthcare providers. Proficient in maintaining patient confidentiality and adhering to HIPAA regulations while utilizing evidence-based tools for continuous improvement.

Highest-signal resume keywords

Clinical ExperienceCase Management PracticeRegistered Nurse (RN) LicenseCertified Case Manager (CCM)Knowledge of Health Insurance

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Care Management PlansPatient AssessmentResource ManagementData RecordingEvidence-Based ToolsLean MethodologiesContractual Benefits KnowledgeCommunity Services KnowledgeHealthcare Resource QuestionsPerformance Expectations

Soft Skills

Effective CommunicationIndependenceClient AdvocacyProblem SolvingInterpersonal Skills

Certifications & Qualifications

Certified Case Manager (CCM)Registered Nurse (RN)Licensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)Licensed Clinical Social Worker (LCSW)

Industry Keywords

HIPAA CompliancePatient ConfidentialityHealth and Human ServicesCost-Effective CareClient-Centered Care

About the role

Key responsibilities & impact

Facilitate client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation
Collect and assess patient information to develop comprehensive, individualized care management plans
Promote appropriate utilization and cost-effective care and services
Link clients with appropriate providers and resources across health and human services and care settings
Ensure care is safe, effective, client-centered, timely, efficient, and equitable
Communicate with clients, payers, primary care providers, and other service professionals
Maintain client privacy, confidentiality, health, and safety in accordance with applicable standards and regulations
Answer medical or contract interpretation questions from internal departments, physicians, and providers
Assist employers and agents with healthcare resource and procedure questions
Use evidence-based tools and lean methodologies for continuous improvement
Meet department and company performance and attendance expectations
Follow PacificSource privacy policy and HIPAA requirements
Perform other duties as assigned

Requirements

What you’ll need

Minimum of three (3) years of clinical experience, including case management
Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required
Certified Case Manager Certification (CCM) accredited by CCMC required at time of hire or within two years of hire date
Knowledge of health insurance and state-mandated benefits
Experience and expertise in case management practice
Knowledge of contractual benefits and options outside contractual benefits
Knowledge of community services, providers, vendors, and facilities
Ability to use computerized systems for data recording and retrieval
Ability to maintain patient confidentiality, privacy, and health records security
Ability to work independently with minimal supervision
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Ability to stoop, bend, sit and/or stand for extended periods, perform repetitive motions, and lift and carry files and business materials

Benefits

Comp & perks

Full-time employment
Work-from-home arrangement
Equal opportunity employment
Travel approximately 5% of the time