Care Management Clinician – Team Lead

PacificSource Health Plans

. Manage Clinical Care Managers across assigned lines of business .

Posted 10/15/2026full-timeRemote • North Carolina • 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 resource management, while effectively leading and developing teams. Proficient in utilizing evidence-based tools and methodologies to improve departmental performance and processes.

Highest-signal resume keywords

Clinical Case ManagementRegistered Nurse (RN) LicenseCertified Case Manager (CCM)Health Plan ExperienceLean Methodologies

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 EvaluationWord ProcessingSpreadsheet ManagementPresentation Software

Soft Skills

Effective CommunicationAdult Education SkillsGroup LeadershipProblem SolvingConflict Resolution

Tools & Technologies

Audio-Visual EquipmentComputer Applications

Certifications & Qualifications

Licensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)Licensed Clinical Social Worker (LCSW)

Industry Keywords

Health InsuranceState-Mandated BenefitsProcess ImprovementCustomer ServiceTeam Operations

About the role

Key responsibilities & impact

Manage Clinical Care Managers across assigned lines of business
Hire, train, coach, counsel, supervise, and evaluate team members
Lead development, implementation, operation, and maintenance of assigned programs, services, and functions
Monitor team workflow, caseloads, assignments, volume, timelines, accuracy, customer service, and performance measures
Improve department performance, processes, and outcomes using lean methodologies and visual boards
Orient and train new hires
Participate in hiring, promotion, and termination decisions
Assist with interdepartmental process improvement
Serve as liaison with PacificSource departments and community partners
Serve on internal and external committees and communicate pertinent information to the team
Promote and utilize 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 updated policies, procedures, and processes to team members
Facilitate team operations, knowledge 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 five years of clinical experience, including case management experience
Minimum three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly 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 (CCM) certification accredited by CCMC required at hire or within two years of hire
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
Strong analytical and organizational skills
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
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Approximately 5% travel required
Ability to stoop, bend, sit and/or stand for extended periods, and perform repetitive typing, sorting, and filing
Ability to lift and carry files and business materials

Benefits

Comp & perks

Equal opportunity employment
Work-from-home arrangement in North Carolina
Ergonomically configured equipment
Professional development through orientation, training, coaching, and ongoing education
Annual reviews and opportunities for promotion
Travel approximately 5% of the time