Care Management Clinician

PACIFICSOURCE

. 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

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Demonstrates expertise in case management practices, including advocacy, assessment, planning, and resource management, while ensuring compliance with HIPAA regulations and maintaining patient confidentiality. Proficient in utilizing evidence-based tools and lean methodologies for continuous improvement in client care.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCertified Case Manager (CCM)Case Management PracticeHealth Insurance KnowledgeEffective Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementPatient AssessmentResource ManagementCare PlanningData RecordingEvidence-Based ToolsLean MethodologiesClient AdvocacyHealth Record SecurityCommunity Services Knowledge

Soft Skills

CollaborationActive ListeningOrganizational SkillsProblem SolvingTeamwork

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

HIPAA ComplianceClient-Centered CareHealthcare Resource ManagementInsurance Industry ExperiencePatient Confidentiality

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 throughout 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 delivery professionals
Maintain client privacy, confidentiality, health, and safety through advocacy and adherence to applicable standards and regulations
Provide quality customer service to PacificSource personnel
Serve as an internal resource for medical or contract interpretation questions
Assist employers and agents with healthcare resource and procedure questions
Use effective written and verbal communication
Utilize and promote evidence-based tools
Utilize lean methodologies for continuous improvement
Meet department and company performance and attendance expectations
Follow PacificSource privacy policy and HIPAA laws and regulations
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, including advocacy, assessment, planning, communication, education, resource management, and service facilitation
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 establish and maintain relationships with community services and providers
Ability to maintain current clinical knowledge base and certification
Ability to work independently with minimal supervision
Ability to read and comprehend written and spoken English
Clear and effective communication skills
Insurance industry experience preferred
Accountability, collaboration, flexibility, active listening, organizational skills, problem solving, and teamwork

Benefits

Comp & perks

Work-from-home location (WFH: FL)
Travel required approximately 5% of the time
Equal opportunity employment
Employer-supported diversity, equity, inclusion, and social justice efforts