Case manager job description
Updated March 14, 2024
9 min read
Case Managers are social workers whose main responsibility is to gain an in-depth understanding of their patients' situations and to foster a deep connection to effectively liaise between the patients and their options for treatment or healthcare. They should have the emotional capacity to work with troubled individuals, people with mental health disorders, or rehabilitation needs.
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Example case manager requirements on a job description
Case manager requirements can be divided into technical requirements and required soft skills. The lists below show the most common requirements included in case manager job postings.
Sample case manager requirements
- Bachelor's degree in social work, psychology or related field
- Minimum of 2 years' experience in a case management role
- Knowledge of local community resources and agencies
- Familiarity with relevant laws and regulations
- Proficient in use of case management software
Sample required case manager soft skills
- Strong problem solving and analytical skills
- Excellent communication and interpersonal skills
- Ability to work independently and as part of a team
- Highly organized; capable of multi-tasking
Case manager job description example 1
CVS Health case manager job description
The Large Case Pensions Manager will supervise a team of pension benefits professionals, manage client relationships and coordinate internal processes and projects.-Supervise, train, coach, and develop a team of pension benefits consultants in establishing new benefits on LCP's benefit payment system-Manage client relationships with pension plan sponsors, plan administrators, disbursing agents, and other third party consultants-Ensure accurate calculation/adjustment of benefits -Monitor and enforce compliance with all applicable laws, regulations, and Aetna policies, contracts-Resolve business and process problems, recommend process improvement initiatives, and lead improvement projects-Promote a positive and mutually-supportive team environment-Act as liaison between business units
Pay Range
The typical pay range for this role is:
Minimum: 60,300
Maximum: 126,600
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
5 or more years of analytical, math and/or customer service experience3 or more years of management and/or leadership experience
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
-Knowledge of LCP systems and operations-Expertise in retirement plan history, regulations, and group annuity products-Proven leadership, training and communication skills-Strong analytical ability-Experience with Microsoft Office products (Word, Excel, Outlook, Access)
Education
Bachelor's degree or equivalent work experience required.
Business Overview
Bring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Pay Range
The typical pay range for this role is:
Minimum: 60,300
Maximum: 126,600
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
5 or more years of analytical, math and/or customer service experience3 or more years of management and/or leadership experience
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
-Knowledge of LCP systems and operations-Expertise in retirement plan history, regulations, and group annuity products-Proven leadership, training and communication skills-Strong analytical ability-Experience with Microsoft Office products (Word, Excel, Outlook, Access)
Education
Bachelor's degree or equivalent work experience required.
Business Overview
Bring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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Case manager job description example 2
Ardent Health Services case manager job description
Join Hillcrest as a Full Time, Day Shift, Case Manager!
Who We Are
Hillcrest HealthCare System (HHS) is changing lives for the better, together. Serving northeastern Oklahoma, the system includes:
•9 hospitals: Hillcrest Medical Center, Hillcrest Hospital South, Oklahoma Heart Institute, Tulsa Spine & Specialty Hospital, Bailey Medical Center, Hillcrest Hospital Cushing, Hillcrest Hospital Claremore, Hillcrest Hospital Henryetta, Hillcrest Hospital Pryor
•2 physician groups: Oklahoma Heart Institute and Utica Park Clinic
•6,250 employees
•322 employed providers
•1,235 licensed beds
•Nearly 150,000 patients treated per year
•More than 110,000 ER visits per year
•$27 million in capital improvements in 2016
HHS is currently looking for a member to join our team! After meeting our leadership team, you will learn how our Utilization Review department is powered by our purpose of caring for people - our employees, our patients and one another. With great teamwork and a knowledgeable, tenured staff, we offer great learning opportunities to grow your career, while doing what you love most - caring for people. If you meet the minimum requirements below, enjoy work that is valued, has purpose and you want to join our team, please apply today!
Responsibilities
What You'll Bring
1-3 years exprerience in a related field OK RN Licensure required, CCM preferred Associate's degree required, Bachelors Degree is a plus Must have a passion for excellence Must demonstrate excellent English grammar and writing skills Professionalism displayed through sound judgement, initiative, and flexibility Good interpersonal, communication, team-work, and customer service skills Strong organizational, problem-solving and follow-through skills Ability to multi-task constantly, react to changes quickly/productively, and tolerate interruptions Ability to perform work when no directions are given, and give directions to others
Qualifications
What You'll Do
To manage individual's health needs through the full continuum of care while ensuring and facilitating the achievement of quality, clinical and financial outcomes. Assesses the ongoing needs of the patient/family and makes referrals to the appropriate community resources or other health care services. The case manager uses a clinical reasoning process for assessing, planning, implementing and evaluating the plan of care while ensuring that coordination of services are done in a timely manner. The case manager is held accountable to ensure that discharge planning is appropriate, timely and communicated to the patient, family and health care team. The case manager will perform utilization review in accordance with InterQual criteria, which will assure appropriate use of health care resources. The nurse case manager is expected to adhere to and abide by the rules and regulations set forth by the Oklahoma Board of Nursing. Must be able to demonstrate awareness and appropriateness in the care of patient's at end of life.
Communicates effectively and demonstrates ability to assess and interpret data about the patient's status in order to identify each patient's age specific needs and provide the care needed by pediatric, adolescent, young adult, middle-aged and geriatric patient groups. Demonstrates knowledge of cultural diversity, the ability to provide care and service and exhibit the communication skill necessary to interact effectively with the customer.
Who We Are
Hillcrest HealthCare System (HHS) is changing lives for the better, together. Serving northeastern Oklahoma, the system includes:
•9 hospitals: Hillcrest Medical Center, Hillcrest Hospital South, Oklahoma Heart Institute, Tulsa Spine & Specialty Hospital, Bailey Medical Center, Hillcrest Hospital Cushing, Hillcrest Hospital Claremore, Hillcrest Hospital Henryetta, Hillcrest Hospital Pryor
•2 physician groups: Oklahoma Heart Institute and Utica Park Clinic
•6,250 employees
•322 employed providers
•1,235 licensed beds
•Nearly 150,000 patients treated per year
•More than 110,000 ER visits per year
•$27 million in capital improvements in 2016
HHS is currently looking for a member to join our team! After meeting our leadership team, you will learn how our Utilization Review department is powered by our purpose of caring for people - our employees, our patients and one another. With great teamwork and a knowledgeable, tenured staff, we offer great learning opportunities to grow your career, while doing what you love most - caring for people. If you meet the minimum requirements below, enjoy work that is valued, has purpose and you want to join our team, please apply today!
Responsibilities
What You'll Bring
1-3 years exprerience in a related field OK RN Licensure required, CCM preferred Associate's degree required, Bachelors Degree is a plus Must have a passion for excellence Must demonstrate excellent English grammar and writing skills Professionalism displayed through sound judgement, initiative, and flexibility Good interpersonal, communication, team-work, and customer service skills Strong organizational, problem-solving and follow-through skills Ability to multi-task constantly, react to changes quickly/productively, and tolerate interruptions Ability to perform work when no directions are given, and give directions to others
Qualifications
What You'll Do
To manage individual's health needs through the full continuum of care while ensuring and facilitating the achievement of quality, clinical and financial outcomes. Assesses the ongoing needs of the patient/family and makes referrals to the appropriate community resources or other health care services. The case manager uses a clinical reasoning process for assessing, planning, implementing and evaluating the plan of care while ensuring that coordination of services are done in a timely manner. The case manager is held accountable to ensure that discharge planning is appropriate, timely and communicated to the patient, family and health care team. The case manager will perform utilization review in accordance with InterQual criteria, which will assure appropriate use of health care resources. The nurse case manager is expected to adhere to and abide by the rules and regulations set forth by the Oklahoma Board of Nursing. Must be able to demonstrate awareness and appropriateness in the care of patient's at end of life.
Communicates effectively and demonstrates ability to assess and interpret data about the patient's status in order to identify each patient's age specific needs and provide the care needed by pediatric, adolescent, young adult, middle-aged and geriatric patient groups. Demonstrates knowledge of cultural diversity, the ability to provide care and service and exhibit the communication skill necessary to interact effectively with the customer.
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Case manager job description example 3
Centene case manager job description
You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the Integrated Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.
• Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life and ensure an integrated approach to address complex issues.
• Understand and comply with NCQA guidelines and HEDIS measures.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
Additional responsibilities for LHCC (LA) for only DOJ positions:
• Each position will be the delegated agency's single point of contact to coordinate the overall CM activities provided to the target population
• Review and approve the initial and ongoing assessment and care plan to ensure requirements are met
• Coordinate service request/authorizations with UM and ensure agreement is aligned between the member, agency, and MCO
• Facilitate member linkages to MCO-based services and programs in collaboration w/ agency staff
• Assist members and/or agency staff w/ transportation to healthcare appointments
• Communicate status of member health indicators with agency staff that can contribute the successful community living of members
• Participate in weekly rounds w/ agency staff
• Other duties as assigned
Education/Experience: Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC, or a PhD, PsyD or RN. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.
License/Certification: Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD or RN license in applicable state.
For New Hampshire Healthy Families: LICSW, LCMHC, LMFT, PsyD, MLADC, BCBA, or PhD license required. Candidates with active medical/social work licenses in good standing in other states than NH, must obtain the NH equivalent within 90 days of hire. Active driver's license in good standing preferred.
For Iowa Total Care: LISW, LMHC, LMFT or RN required
For the IDD populations:
Education/Experience: Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT, LPC, PhD, PsyD, RN, ABA, or BCBA. ABA or BCBA highly preferred. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.
License/Certification: Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD, RN, ABA or BCBA license in applicable state. ABA or BCBA highly preferred.
For Sunflower Health Plan: Valid Driver's license SED (Serious Emotional Disturbance) Waiver staff.
For Oklahoma Complete Health Only: Employees may be required to be on call. Employees will be required to make member visits.
For Shared Services: Clinical licensure for multiple states is required
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
**TITLE:** Close in Taleo - Behavioral Case Mgr
**LOCATION:** Various, Indiana
**REQNUMBER:** 1326922
Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the Integrated Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.
• Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life and ensure an integrated approach to address complex issues.
• Understand and comply with NCQA guidelines and HEDIS measures.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
Additional responsibilities for LHCC (LA) for only DOJ positions:
• Each position will be the delegated agency's single point of contact to coordinate the overall CM activities provided to the target population
• Review and approve the initial and ongoing assessment and care plan to ensure requirements are met
• Coordinate service request/authorizations with UM and ensure agreement is aligned between the member, agency, and MCO
• Facilitate member linkages to MCO-based services and programs in collaboration w/ agency staff
• Assist members and/or agency staff w/ transportation to healthcare appointments
• Communicate status of member health indicators with agency staff that can contribute the successful community living of members
• Participate in weekly rounds w/ agency staff
• Other duties as assigned
Education/Experience: Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC, or a PhD, PsyD or RN. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.
License/Certification: Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD or RN license in applicable state.
For New Hampshire Healthy Families: LICSW, LCMHC, LMFT, PsyD, MLADC, BCBA, or PhD license required. Candidates with active medical/social work licenses in good standing in other states than NH, must obtain the NH equivalent within 90 days of hire. Active driver's license in good standing preferred.
For Iowa Total Care: LISW, LMHC, LMFT or RN required
For the IDD populations:
Education/Experience: Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT, LPC, PhD, PsyD, RN, ABA, or BCBA. ABA or BCBA highly preferred. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.
License/Certification: Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD, RN, ABA or BCBA license in applicable state. ABA or BCBA highly preferred.
For Sunflower Health Plan: Valid Driver's license SED (Serious Emotional Disturbance) Waiver staff.
For Oklahoma Complete Health Only: Employees may be required to be on call. Employees will be required to make member visits.
For Shared Services: Clinical licensure for multiple states is required
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
**TITLE:** Close in Taleo - Behavioral Case Mgr
**LOCATION:** Various, Indiana
**REQNUMBER:** 1326922
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Updated March 14, 2024
Updated March 14, 2024