Care Management Clinician – Team Lead

PacificSource Health Plans

. Manage Clinical Care Managers for assigned lines of business .

Posted 10/15/2026full-timeRemote • Florida • United StatesSenior💰 $83,212 - $137,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in clinical case management, including advocacy, assessment, and service facilitation, while effectively leading and developing teams. Proficient in utilizing health insurance knowledge and process improvement methodologies to enhance service delivery and operational efficiency.

Highest-signal resume keywords

Clinical Case ManagementRegistered Nurse (RN) LicenseCertified Case Manager (CCM)Health Plan ExperienceSupervisory Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case Management PracticeUtilization ManagementBehavioral Health ManagementAnalytical SkillsOrganizational SkillsInformation Systems ProficiencyReport EvaluationAdult Education/Teaching SkillsProcess ImprovementResource Management

Soft Skills

LeadershipCollaborationCommunicationCritical ThinkingDecision Making

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointAudio-Visual Equipment

Certifications & Qualifications

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

Industry Keywords

Health ServicesHealth InsuranceState Mandated BenefitsEvidence-Based ToolsLean MethodologiesKey Performance IndicatorsCustomer ServiceTeam OperationsConflict ResolutionProgram Development

About the role

Key responsibilities & impact

Manage Clinical Care Managers for assigned lines of business
Hire, train, coach, counsel, and evaluate team member performance
Perform routine day-to-day program functions as needed
Participate in program development and implementation
Supervise and guide direct reports and department staff on company policies, procedures, and operations
Manage team task quality, productivity, workflow, and overall Health Services effectiveness
Resolve issues and improve processes and outcomes
Lead development, implementation, operation, and maintenance of assigned programs, services, or functions
Monitor daily workflow, caseloads, task distribution, and processing
Orient and train new hires
Provide ongoing supervision, training, evaluation, and leadership, including annual reviews and involvement in promotions or terminations
Participate in hiring decisions with leadership and Human Resources
Monitor team assignments for volume, timelines, accuracy, customer service, and quality measures
Support process improvement using lean methodologies, visual boards, and key performance indicators
Liaise with PacificSource departments and community partners to coordinate services and information
Serve on internal and external committees and report pertinent communications
Promote use of evidence-based tools
Maintain a modified caseload
Investigate and resolve process-related issues and facilitate conflict resolution
Oversee and assist with service and information for members, providers, employers, agents, and other customers
Provide backup to departmental teams or management staff
Communicate policy, procedure, and process updates to team members
Facilitate team operations through information sharing, problem-solving, and standardization of Health Services operations
Represent the Health Services Department internally and externally
Perform other duties as assigned

Requirements

What you’ll need

Minimum of five years clinical experience, including case management experience
Minimum of three years direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly preferred
Prior supervisory experience preferred
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
Thorough knowledge and experience in case management practice, including advocacy, assessment, planning, communication, education, resource management, and service facilitation
Effective adult education/teaching and/or group leadership skills
Ability to work with people who have various health issues and concerns
Strong analytical and organizational skills with experience using information systems and computer applications
Ability to develop, review, and evaluate utilization and case management reports
Strong computer skills including Word, Excel, and PowerPoint
Ability to use audio-visual equipment
Ability to work independently with minimal supervision
Skills in accountable leadership, collaboration, written/verbal communication, critical thinking, decision making, influencing, active listening, organizational skills, planning and organization
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing motions, and lift/carry files and business materials

Benefits

Comp & perks

Equal opportunity employment
Work inside a general office setting with ergonomically configured equipment
Travel approximately 5% of the time
Company values and culture focused on teamwork, customer service, open communication, community improvement, social justice, equity, diversity and inclusion, creativity, innovation, and excellence