The Bilingual LeadCareManager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed.
Responsibilities
Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language.
Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health.
Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans.
Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care.
Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure.
Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability.
Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively.
Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals.
Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures.
Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance.
Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care.
Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions.
Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions.
Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone.
Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development.
Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery.
Open to seeing patients in their home or their location of preference.
Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency.
Help bridge cultural gaps that may impact communication, trust, adherence, or engagement.
Skills Required
Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level.
Strong ability to build rapport and trust with diverse, high-need member populations.
Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools.
Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals.
Demonstrated skill in conducting holistic assessments and developing person-centered care plans.
Experience with motivational interviewing, trauma-informed care, or health coaching.
Strong organizational and time-management skills, with the ability to manage a complex caseload.
Excellent written and verbal communication skills across in-person, telephonic, and digital channels.
Ability to work independently, make sound decisions, and escalate appropriately.
Knowledge of Medi-Cal, SDOH, community resources, and social service navigation.
High attention to detail and commitment to accurate, audit-ready documentation.
Ability to remain calm, patient, and professional while supporting members facing instability or crisis.
Comfortable with field-based work, home visits, and interacting in diverse community environments.
Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences.
Competencies
Member Advocacy: Champions member needs with urgency and integrity.
Operational Effectiveness: Executes workflows consistently and flags process gaps.
Interpersonal Effectiveness: Builds rapport with diverse populations.
Collaboration: Works effectively within an interdisciplinary care model.
Decision Making: Uses judgment to escalate or intervene appropriately.
Problem Solving: Identifies issues and creates practical, timely solutions.
Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes.
Cultural Competence: Engages members with respect for their lived experiences.
Documentation Excellence: Produces accurate, timely, audit-ready notes every time.
Strong empathy, cultural competence, and commitment to providing individualized care.
Ability to work effectively within a multidisciplinary team environment.
Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation)
Job Requirements
Education:
Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered.
Licensure:
Not required; certification in care coordination or CHW training is a plus.
Experience:
1-3 years of caremanagement or case management experience, preferably with high-need Medi-Cal populations.
Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred.
Familiarity with Medi-Cal, ECM, and community resource navigation.
Travel Requirements:
Regular travel for in-person home or community visits (up to 45%).
Physical Requirements:
Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
$36k-47k yearly est. 2d ago
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Remote Care Manager
Teksystems 4.4
Remote job
*CareManager (Remote)* *Start Date : 2/17* *Work Environment:* * Fully remote; must have a quiet workspace and provide a photo of designated area. * Shift: 8:00 AM - 8:00 PM EST (8-hour shift) * Training: 8:30 AM - 5:00 PM EST for 2 weeks
CareManagers make high-volume outbound calls to payors/pharmacy benefit managers (PBMs) to verify copay support eligibility for commercially insured patients. This is a phone-intensive role (up to 95% of shift on calls) requiring strict adherence to scripts, accurate documentation, and professional customer service.
*Key Responsibilities:*
* Make outbound calls to PBMs/payors for copay eligibility; maintain 95% phone engagement.
* Follow approved call guides and compliant scripts.
* Identify and record plan types (e.g., Traditional, Accumulator, Maximizer).
* Use PBM-specific workflows to gather benefit details.
* Document all interactions accurately in CRM/telephony tools in real time.
* Manage follow-up tasks promptly.
* Maintain proper telephony status and campaign selection.
* Adhere to compliance, privacy, and quality standards.
* Collaborate professionally with PBM contacts and internal teams.
*Requirements:*
* *Experience:* 1+ year in a call center or high-volume phone environment preferred.
* *Skills:* Strong attention to detail, excellent verbal communication, ability to follow scripts and document accurately.
* *Technical:* Reliable high-speed internet, computer with webcam, and ability to work in a quiet space (photo required).
* *Availability:* Must commit to training schedule and assigned shift.
*Job Type & Location*
This is a Contract position based out of Houston, TX.
*Pay and Benefits*The pay range for this position is $21.00 - $21.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*This is a fully remote position.
*Application Deadline*This position is anticipated to close on Jan 16, 2026.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Are you eager to leverage your skills and experience in a dynamic new career opportunity? ServiceLink, the unrivaled leader in the mortgage industry, seeks an action-oriented individual with proven management success and the initiative to proactively resolve escalated issues to fill the position of Manager, eClose. The ideal candidate will be exceedingly motivated to conquer bold challenges and drive impactful results in a culture which promotes entrepreneurship through empowerment. If you possess strong interpersonal awareness and the motivation to lead high performing teams to new levels of success, we invite you to apply today. This is an exciting time to join ServiceLink, where the demand for exceptional performance is rewarded with meaningful and self-directed advancement possibilities.
Applicants must be currently authorized to work in the United States on a full-time basis and must not require sponsorship for employment visa status now or in the future.
A DAY IN THE LIFE
In this role, you will…
· Oversee the eClose Department. The eClose Department manages both RON & iPEN processes.
· Be responsible for staff performance, attendance, training, payroll approval, and staffing decisions
· Assess the overall health & performance of the eClose vendor network and work with the team to improve the network's performance
· Grow & maintain the eClose vendor panel
· Accountable to Maintain & Monitor expected COGS, client-level SLAs around customer satisfaction, vendor quality & any other eClose-related metrics
· Participate in client audits
· Keep up with industry news that may be related to eClosing and eNotary requirements
· Identify areas for growth and improvement and implement plans to meet those needs
· Address any escalated issues for eClosings
· Ensure the proper adherence to any regulations related to eClose options
· Provide departmental reporting to upper management
· Address any escalated client, vendor, or employee related issues
WHO YOU ARE
You possess …
· Previous management experience and title, closing or mortgage industry experience
· High School diploma or equivalent required
· Ability to recognize problems outside the normal mandated company, client and state regulations, guidelines and requirements
· The ability to multitask in a fast-paced environment, especially the ability to meet tight deadlines for our clients
· Good organizational skills, the ability to handle multiple tasks simultaneously and demonstrate good communication and customer service skills
Responsibilities
· Manage the eClose department for production, performance & quality. The eClose Department manages both RON & iPEN processes.
· Ensure all daily work is done by the Team
· Manage workload issues across teams and propose and implement efficiency initiatives as deemed necessary
· Develop and maintain processes and procedures for use within the department and for external vendors, as needed
· Perform audits of employee work and make sure tasks are completed accurately
· Responsible for coaching & counseling employees
· Set production metrics for the department and review employee production to determine if employees are meeting the goals
· Assist Team Members and Team Leads in resolution of issues
· Coach and counsel team members when issues are found
· Plan for and have appropriate staffing for month end and to cover days off, when applicable
· Ensure team members have vacations scheduled appropriately throughout the year
· Build and maintain employee morale
· Monitor and approve department payroll
· Responsible for completing annual employee reviews
· Maintain professional relationships with eNotary vendors
· Responsible for reviewing the performance of the eNotary vendor network and adjusting as necessary
· Responsible for determining the discipline when it comes to vendor counseling
· Identify areas for improvement and implement plans to address
· Evaluate reports that depict client activity to ensure efficient team operations and client satisfaction
· Address any escalated client, vendor, or employee related issues in a professional and timely manner.
· Advise management of any escalated issues or concerns
· Responsible for departmental reporting
· Communicate & coordinate with other ServiceLink departments, as necessary, to ensure we are meeting client expectations.
· Participate in client audits, including pre-audit questionnaires and responses
· Make recommendations to Director for staffing levels, overtime, and movement of employees between teams
· Interview and recommend new candidates for hiring, when needed
· Recommend systems and process enhancements to reduce processing times and improve accuracy
· Adhere to company policies and procedures
· All other duties as assigned
Qualifications
· High School diploma or equivalent required
· Previous management experience and title, closing or mortgage industry experience
· Must be able to work additional hours, if needed, to ensure completion of necessary work and success of department
· Must be able to multitask
· Proficiency in Microsoft Office products, including Excel, Word & Teams
· Tech savvy and forward thinking
· Detail oriented, efficient and organized
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$53k-77k yearly est. Auto-Apply 57d ago
Lead Care Manager
Carolina Health Centers, Inc. 4.2
Remote job
General Description: The LeadCareManager is responsible for coordinating and delivering CareManagement and related care coordination services for patients with multiple chronic conditions. This position focuses on building trusting relationships with patients, developing individualized care plans, and collaborating with the patient's care team to improve health outcomes, reduce avoidable hospitalizations, and enhance patient engagement. In addition to core caremanagement duties, the LeadCareManager serves as a mentor and clinical resource for newly hired caremanagers, assists in onboarding and training, supports the Chronic CareManagement Coordinator in resolving operational issues, and provides coverage during CCM Coordinator's absence. This role also contributes to strategic planning and quality improvement initiatives within the CareManagement Programs. The role is primarily remote, using phone, electronic health record (EHR) tools, and telehealth platforms to provide services.
Duties and Responsibilities:
* Provide monthly caremanagement services for assigned patients in accordance with CMS guidelines.
* Perform comprehensive assessments, including medical, social, functional, and behavioral health needs.
* Develop, implement, and update patient-centered care plans with input from patients, families, and providers.
* Conduct monthly billable check-ins, track cumulative time, and ensure accurate, timely, and compliant documentation of all patient interactions in EHR.
* Coordinate care across providers, specialists, hospitals, and community resources.
* Support Remote Patient Monitoring (RPM) initiatives by reviewing data, identifying trends, and intervening as needed.
* Provide health coaching and patient education related to chronic disease management.
* Monitor and address care gaps, preventative screenings, and medication adherence.
* Identify and escalate high-risk patients for provider review.
* Participate in quality improvement initiatives related to caremanagement and population health.
* Provide Mentorship for CareManagers.
* Train and orient new CareManagers. This may mean time in office vs. remote.
* Provides coverage and serves as point of contact in the absence of CCM Coordinator.
* Operational support during program startup.
* Observing and giving strategic input on workflows and quality initiatives.
Reporting Relationships
Responsible to:
* Directly supervised by the Chronic CareManagement Coordinator
Workers Supervised:
* None
Interrelationships:
* Interacts directly with patients and family members via telephone or MyChart.
* Represents CHC and the practice site to the public in a professional manner.
* Works closely with CCM team, Quality and Population Health team, Administrative Leaders and Directors, and providers and staff at all clinics.
This job description is not designed to cover or contain an exhaustive list of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.
Requirements
Requirements:
All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of: honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation.
In addition, this position requires:
* Education:
* ADN or BSN (BSN preferred)
* Licensure and Credentials:
* Current, unrestricted nursing license in South Carolina or a compact state.
* Work Experience:
* Minimum 2 years of nursing experience, preferably in primary care, caremanagement, case management, or chronic disease management.
* Skills:
* Able to read, write and communicate effectively orally and in writing
* Proficient in use of computer and keyboard
* Proficiency in using electronic health records (EPIC preferred)
* Able to establish and maintain effective working relationships
* Excellent interpersonal and communication abilities
* Strong communication skills and ability to build rapport with patients remotely.
* Ability to work independently, manage time effectively, and prioritize patient needs.
* Knowledge of CMS billing guidelines and documentation standards for caremanagement programs.
* Experience with telehealth, remote patient monitoring, or population health programs.
* Physical Abilities:
* Have the hand-eye coordination and manual dexterity needed to operate a computer, telephone, copier, standard office equipment, and medical equipment.
* Required to talk and have a normal range of hearing and eyesight to be able to collect data and record where appropriate (i.e. computer and/or paper).
* Vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus
* Work Environment:
* Reliable internet access and private, HIPPA-compliant remote work environment.
* Remote, work-from-home position with structured daily schedule.
* Occasional travel to clinics, training, or community events may be required.
* Computer, phone, and secure access to EHR will be provided.
* Requirements for out-of-town and/or overnight travel are minimal.
$26k-54k yearly est. 53d ago
Care Manager (RN) - Remote in OH
Molina Talent Acquisition
Remote job
Provides support for caremanagement/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for caremanagement based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.
• Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• Caremanager RNs may be assigned complex member cases and medication regimens.
• Caremanager RNs may conduct medication reconciliation as needed.
• 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications
• At least 2 years experience in health care, preferably in caremanagement, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Preferred Qualifications
• Certified Case Manager (CCM).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
$68k-117k yearly est. Auto-Apply 14d ago
Care Manager - Santa Cruz
Omatochi
Remote job
Omatochi is actively seeking a compassionate and detail-oriented CareManager to join our team. In this non-medical role, you will play a crucial part in coordinating and overseeing support services for our clients. The CareManager will work closely with various stakeholders to ensure our clients receive the assistance and resources needed to improve their quality of life. The ideal candidate for this position is empathetic, organized, and possesses excellent communication skills.
Responsibilities:
Client Assessment and Support Planning:
Conduct thorough assessments of clients' needs, considering their personal, social, and emotional requirements.
Develop tailored support plans in collaboration with clients, their families, and relevant agencies.
Coordinate with community resources to provide clients with appropriate services and assistance.
Care Coordination and Advocacy:
Serve as the main point of contact for clients, connecting them with relevant services and programs.
Advocate for clients' needs, ensuring they receive timely and adequate support from various organizations and service providers.
Monitor the progress of support plans and adjust them as necessary to meet clients' changing requirements.
Client and Family Education:
Educate clients and their families about available support services, community resources, and self-help techniques.
Provide guidance on effective coping strategies and assist in developing life skills.
Address clients' concerns and queries, building a trusting and supportive relationship.
Documentation and Reporting:
Maintain accurate records of client assessments, support plans, and interactions.
Generate detailed reports on client outcomes, program effectiveness, and areas for improvement.
Ensure compliance with organizational protocols and reporting requirements.
Collaboration and Professional Development:
Collaborate closely with community organizations, social workers, and relevant agencies to enhance the overall quality of client support.
Participate in regular team meetings, training sessions, and workshops to stay informed about the latest developments in social services and caremanagement.
Pursue continuous professional development, seeking opportunities to expand knowledge and skills in the field of caremanagement.
Qualifications:
Valid Drivers License and Vehicle
Bachelor's degree in Social Work, Psychology, Counseling, Human Services, or a related field.
Proven experience in non-medical caremanagement, case management, or social services.
Strong understanding of social service regulations, policies, and procedures.
Excellent interpersonal skills, including active listening and empathy.
Ability to work independently, prioritize tasks, and manage time efficiently.
Proficiency in using case management software and other relevant tools.
Benefits:
Competitive salary and performance-based incentives.
Comprehensive benefits package, including health, dental, and vision insurance.
Generous paid time off, including vacation, personal days, and holidays.
Ongoing professional development opportunities.
Region and Travel:
This is a position with a strong field-based component. While the incumbent will have flexibility to work from home, they are expected to travel extensively-approximately 50% to 80% of the time-within Santa Cruz County. This role requires a high level of mobility and availability to attend in-person visits, community events, and other field-based responsibilities throughout the geographic area of responsibility.
Mileage Reimbursement / Vehicle Allowance: Travel-related expenses are reimbursed and whether a monthly stipend is provided for vehicle use.
Scheduling Flexibility: Incumbent has autonomy over scheduling and is responsible for balancing field and administrative work.
Omatochi is committed to creating an inclusive and diverse work environment. We encourage applications from candidates of all backgrounds and experiences.
$74k-127k yearly est. Auto-Apply 60d+ ago
Care Manager
April Parker Foundation
Remote job
About the role
The April Parker Foundation is seeking compassionate, detail-oriented CareManagers (Generalists) to deliver Enhanced CareManagement (ECM) and Community Supports (CS) services to Medi-Cal members with complex medical, behavioral, and social needs.
You'll work directly with individuals experiencing housing insecurity, chronic illness, or behavioral-health challenges helping them navigate care, access community resources, and achieve stability in health and housing.
This is a field-based / remote role ideal for professionals who value flexibility and meaningful impact.
What you'll do
Conduct outreach, assessments, and individualized care plans for ECM and CS members.
Coordinate medical, behavioral, and social-service supports-including housing navigation and tenancy services.
Complete timely documentation and progress tracking in APF systems.
Provide in-person, telephonic, and virtual encounters based on member needs.
Collaborate with health plans, community partners, and APF multidisciplinary teams.
Maintain strict confidentiality and compliance with Medi-Cal, DHCS, and ILS guidelines.
Compensation
Base Salary (Straight-Time Pay)
Salary is based on your caseload and is calculated using a simple, transparent formula:
Each member = 2 paid hours per member per month (PMPM), at $25.00/hour ($50 PMPM)
Your monthly salary increases as your caseload increases.
Incentive Pay (Additional Earnings)
You earn $40 per member per month for delivery qualified, on top of your base salary.
Bringing total compensation to $90 PMPM, equivalent to $45/hour
Reimbursements & Stipends
Mileage reimbursement at the IRS rate
$50/month phone stipend
Reimbursement for approved work-related expenses
Schedule
Work hours are flexible and self-directed, provided CareManagers meet service delivery requirements and member availability
Qualifications
Minimum 2 years of experience in case management, care coordination, or related field
Knowledge of Medi-Cal CalAIM programs, community resources, and social determinants of health
Excellent documentation, organization, and communication skills
Valid California Driver's License, auto insurance, and reliable transportation
Preferred: Bachelor's degree or CHW certification; CA licensure (LCSW, LMFT, LPCC, RN, etc.)
$25-50 hourly 39d ago
Care Manager
Salvo Health
Remote job
Salvo is looking for an experienced Nurse to support our chronic disease patients. In this role, you'll be a key contributor to the management and delivery of our care program, working closely with our patients, registered dietitians, and partner physicians to provide best-in-class care. You'll use your medical knowledge and product expertise to help our members navigate Salvo Health, assisting in medical and administrative tasks to keep the member moving through the program. Additionally, you'll help shape how we build and scale our product and process. Our ideal candidate is someone who enjoys the challenges of an early-stage start up, is eager to learn, process oriented, and has a patient-first mindset. What You Will do:
Provide exceptional care, disease management and health education to patients
Support goal setting for individual patients asynchronously to help them better manage their chronic conditions
Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors
Help clients understand their motivations and create behavior change plans
Conduct regular outreach to patients, based on their needs and preferences, to support engagement and elicit behavior change
Coordinate with other clinical team members to provide an exceptional patient experience
Develop and maintain professional, support-oriented working relationships with patients and team members
Create and distribute health education materials to individual members as necessary
Work with a cross-functional product team to develop and constantly improve our in-app patient experience
Qualifications:
2+ year of experience as Licensed Practical Nurse or any Nursing license
2+ years of experience in patient-facing or customer-facing roles
Compact state license required, additional licensing may be needed
Bilingual (spanish speaking) a plus
Excellent customer relation skills, as well as written and verbal communication skills
Knowledge of medical terminology and proficiency of general medical office procedures
Familiarity with digital applications like Slack, Coda, Google Workspace, etc.
Strong analytical and proactive problem solving skills
Self-motivated, results-oriented and strategic thinker
Personal passion for health and wellness topics
Must be authorized to work in the United States
Experience working in telehealth or healthcare startup environment preferred
Bonus: Experience working in GI, weight management, and/or with anti-obesity medications such as GLP-1s
Salvo is a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. Our patients are assigned a “whole patient” care team and have seven day a week access to app-based care, using Remote Patient Monitoring (“RPM”) to bill under the patient's insurance. This is a major step forward to go beyond episodic appointments to continuous care at home, and deliver interdisciplinary wraparound care in partnership with the patient's existing local doctor.
Salvo is backed by leading health care investors from innovators like Livongo, Ro, Ginger, Forward, Brightline, Tia, and others. Salvo care draws on expertise from Board-certified specialty physicians, registered dietitians, nurses, psychologists, and therapists who have developed our evidence-based protocols, for a personalized, multi-month journey to better health.
Salvo is the first to bring a scalable and tech-enabled, more integrative approach to these chronic conditions, going beyond treating only the symptoms in order to identify and address the root causes of chronic illness.
Salvo offers a competitive salary and health benefits, a remote work environment, flexible time-off, a larger sense of mission, and professional development and entrepreneurial opportunities. Working alongside a bunch of super talented and friendly people, in a culture that likes to drive constant innovation, and marked by relentless curiosity and a sense of empathy.
Salvo is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
$47k-89k yearly est. Auto-Apply 60d+ ago
Remote Care Manager
Insight Global
Remote job
Insight Global is hiring for a Remote CareManager to support our micro clinic operations in Raleigh, NC. You will work in a virtual setting with providers, paramedics, and patients to partner in the care continuum process. You will lead the clinical onboarding of new contracts, handle referrals & authorizations, and ensure seamless communication with all stakeholders.
Responsibilities will include:
· Develop and monitor care plans in collaboration with multiple providers, adjusting as needed
· Follow up on interventions to prevent unnecessary ER visits and hospital admissions
· Serve as the primary liaison between patients, families, and healthcare staff to ensure seamless communication
· Navigate multiple healthcare platforms including EHRs, payer portals, billing software, and patient messaging systems
· Ensure timely and accurate documentation across systems to support care continuity and compliance
· Verify provider participation, coverage, and pre-authorization requirements with insurance administrators and healthcare facilities
· Optimize client contracts and referral workflows to enhance scalability and efficiency in care coordination
· Schedule and manage appointments, follow-ups, and referrals to specialists and services
· Educate patients on conditions, medications, and treatment plans to promote understanding and adherence
· Track patient progress and address barriers to treatment plan compliance
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: ****************************************************
Skills and Requirements
· RN Licensure or Paramedic Licensure in North Carolina
· Minimum of 3 years of experience in care coordination (care or case management)
· Strong knowledge of insurance benefits, prior authorizations, and referral management
· Proficiency with EMR/EHR systems, payer portals, and standard office software (60% of role)
· Strong communicational & organizational skills - ability to work efficiently with a team
$43k-84k yearly est. 60d+ ago
Geriatric Care Manager
Metrowest Eldercare Management
Remote job
Benefits:
Job you will love
Fulfilling work
Rewarding Career
Supportive Environment
Make a difference for your clients
In Demand
The CareManager is responsible for providing quality professional caremanagement services to all clients and their responsible parties. Our objective is to assist our clients in managing and navigating challenges in aging as well as Adults with physical and mental disabilities and providing the highest quality of life. This includes:
Care Coordination
Managing home health aides
Medical oversight
Interfacing with medical personnel
Advocacy, information and referrals
Qualifications:
Professional and positive approach, commitment to customer service
Self-motivated and work with own initiative
Strong in building relationships, team player and able to communicate at all levels
Recognizes industry trends and problem solves
Respectful of company and client confidentiality; any violation of company or client confidence is immediate grounds for dismissal.
Personalized and compassionate service - focusing on the individual client's wants and needs.
Ability to provide non-directive guidance and facilitate constructive relationships.
Ability to ensure inappropriate placements, duplication of services, and unnecessary hospitalizations are avoided.
Manage time efficiently.
Ability to provide coordinated communication between family members, doctors and other professionals, and service providers.
This is a remote position.
Aging Life Care Professionals offer a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through:
Assessment and monitoring
Planning and problem-solving
Education and advocacy
Family caregiver coaching
This business is independently owned and operated. Your application will go directly to the business, and all hiring decisions will be made by the management. All inquiries about employment at this business should be made directly and not to Aging Life Care Association.
$69k-124k yearly est. Auto-Apply 60d+ ago
Work From Home - Manager in Training
Ao Garcia Agency
Remote job
Are you looking for a work-from-home opportunity where you can grow with a company, help others, and uphold the highest standards of integrity? Are you passionate about making a positive impact on the lives of others? Look no further! We're seeking dedicated individuals to join our team in a financial services position aimed at protecting families.
Why Join Us?1. Make a Difference: Join a team dedicated to protecting families and children through financial services, providing peace of mind and security to those who need it most.2. Work from Home: Enjoy the convenience and flexibility of working remotely, allowing you to create a comfortable and productive work environment while balancing your personal commitments.3. Opportunity for Growth: Grow with a company that values your potential and provides opportunities for advancement, allowing you to build a rewarding career while making a meaningful difference in the lives of others.4. Help Others: Use your skills and expertise to assist families in securing their financial futures, providing them with the support and guidance they need to navigate life's uncertainties with confidence.5. Integrity: Uphold the highest standards of integrity in all aspects of your work, ensuring that every interaction with clients is based on honesty, transparency, and trust worthiness.
Qualifications:• Genuine desire to help others and make a positive impact on their lives.• Strong communication and interpersonal skills.• Ability to work independently and as part of a team.• Integrity and ethical conduct in all professional dealings.
If you're ready to embark on a fulfilling career where you can work from home, help others, and grow with a company that values integrity and compassion, apply now! Take the first step towards a rewarding journey of making a difference in the lives of families and children through financial services.Don't miss out on this opportunity to join a team that's committed to making a meaningful impact. Apply today and become part of our mission to protect and support families and children in need!
*All interviews will be conducted via Zoom video conferencing.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
$61k-102k yearly est. Auto-Apply 8d ago
Manager in Training - Work From Home
Spade Recruiting
Remote job
After a record breaking year with $2.3 million in sales and 46% growth year over year we have decided to open up additional positions for 2022. If you are hard-working, motivated, and a team player then we have a position for you!
Experience in our industry is not required as we have industry-leading training and support to provide you the tools to be successful and achieve your professional and personal dreams. At last, we now have the ability to work from home virtually so we can hire candidates and service customers from all over the country!
Company Accolades:
Forbes Top 24 Happiest Companies To Work For 2017, 2018, 2019, 2020
Fortune 500 Company
Rated A+ Superior on AM best for financial strength
What We Offer:
Full training provided
A fun, energetic and positive team environment
Rapid career growth and advancement opportunities
Weekly pay and bonuses
Virtual Work-From-Home setting
Benefit Reimbursement program after 90 days
Residual Income
Ability to qualify for an all-expenses-paid yearly office trips to exciting and exotic locations (2016 Puerto Rico, 2017 Cancun, 2018 Disney, 2019 Vegas, 2020 Bar Mar Bahamas)
Job Duties:
Inbound and outbound calling
Scheduling appointments with clients who request our benefits
Presenting and explaining insurance products and benefits packages over Zoom video call
Sell and up sell insurance to new and existing clients
Completing applications for insurance products
Report daily numbers
Attend optional training classes
Completing tasks that an underwriter requires to get the client approved for the coverage
Apply now to learn more about what we do and how you can be a part of our team today!
$71k-125k yearly est. Auto-Apply 60d+ ago
Manager, Talent Acquisition (Tech)- Remote, work from home
Recruiters Recruiting Recruiters
Remote job
Freedom Financial Network is a family of companies that takes a people-first approach to financial services, using technology to empower consumers to overcome debt and create a brighter financial future. The company was founded in 2002 by Brad Stroh and Andrew Housser on the belief that by staying committed to helping people, you can ensure better financial outcomes for both the customer and the business. This Heart + $ philosophy still guides the vision of our growing company, which has helped millions of people find solutions for their financial needs.
What began with 2 people in a spare bedroom has now rapidly expanded to a vibrant business that employs over 2,300 employees (known internally as The Freedom Family) in two locations: San Mateo, CA and Tempe, AZ. When you visit either of our offices, you'll understand why our employees have voted us the Best Place to Work for the last several years. It's a place where the Heart + $ philosophy continues to thrive, where we believe that success is only achieved by doing what's right for our customers, our employees, and our communities.
In order to create brighter futures for our clients, employees, and businesses, Freedom Financial Network holds itself to four core values that have grown out of our Heart + $ philosophy: to
care
for everyone around us,
act with integrity
every time,
collaborate
with everybody we work with, and
get better
at what we do every day.
Job Description
The Opportunity:
We're growing and making a real difference in people's lives every day. Are your talents being leveraged to their fullest? Do you have the autonomy to build a truly impactful recruiting function? If not, consider joining us out as we continue to build the most innovative technology teams in the Fintech space!
This is truly a unique opportunity to make your mark and the impact you've always known you could! In this position, the
Manager, Talent Acquisition
(TA) is responsible for driving the overall strategy and day-to-day recruiting operations supporting a variety of technical teams that may include Engineering, Product, Information Technology, Digital Marketing and Data/Strategy as well as other teams as needed. You will leverage your leadership, collaboration and influencing skills to ensure we capture the highest quality candidates through passive talent sourcing, and that we are thoroughly screening, interviewing and on-boarding with the highest sense of urgency, quality and continuous improvement. Reporting to the Vice President of Talent Acquisition, you will play an integral role in the design, deployment and execution of recruiting initiatives, tools and technology, training and development of the recruiting team, and continuous improvement of our processes.
The day-to-day duties include coaching, leading and developing a team of Recruiters and Sourcing Specialists to ensure we deliver on our promise of bringing the very best talent into the company in the shortest timeframe possible. Acting as an expert resource for our Recruiters as they continue their evolution into becoming “Talent Advisors”, you will drive new and innovative talent sourcing strategies, provide expert guidance on selection strategies and building strong relationships with all stakeholders while ensuring a “best in class” candidate and hiring manager experience.
Role location is preferred in Phoenix but will consider remote locations in CA, TX, NV, WA, CO, OR, and UT.
RESPONSIBILITIES:
Leads a team of 4-6 Recruiters who are based in various locations across the US.
Identifies and implements new, creative strategies to locate and “win” top tech talent in this highly competitive market.
Leverage metrics and data to drive performance, continuous improvement and quality talent outcomes for the team, our business groups and the company as a whole.
With clear performance expectations in place, you will coach and guide the recruiters on a daily basis providing support, sourcing and selection strategy assistance, and on-going process improvement.
Builds strong relationships with key stakeholders at all levels from senior staff to VPs to understand talent needs now and in the future. Exceptional influencing skills are key.
Identifies and builds relationships with key external recruiting firms to leverage as needed.
Personally manages the search for executive level openings as needed.
Identify opportunities and participate in the execution of process improvement initiatives.
Collaborate with business leaders, HRBP's and other peers to ensure the best possible recruiting outcomes, candidate experience and new hire retention.
Become a subject matter expert in the utilization and optimization of the ATS and other tools leveraged in the recruiting process.
Qualifications
Minimum QUALIFICATIONS:
· Bachelor's degree highly preferred.
· 5+ years of overall experience in recruiting with at least 4 years in high growth mode corporate setting required.
· 2+ years' experience leading highly successful recruiting teams
· 3+ years of experience recruiting in the technology space (Engineering, Product, BI/Data, etc.) at all levels up to VP.
· Strong analytical and quantitative skills and experience required.
· Proven experience building effective relationships and partnerships across various levels of an organization.
· Talent Advisor certification preferred.
· Advanced talent sourcing certification(s) preferred.
· Proficiency in MS-office necessary; advanced capabilities in Excel, and PowerPoint a strong plus.
Additional Information
All your information will be kept confidential according to EEO guidelines.
$51k-90k yearly est. 13h ago
Care Manager
Sparrowell
Remote job
Hello, how are you?
Are you a LPN that is looking to improve the health of patients that have complex conditions? Do you live within a reasonable driving distance to St. Joseph, MO? Would you like to work from home and travel for the training/occasional meetings?
If you answered yes to the above and have/are:
Savvy with basic software/services such as email, word, excel, etc.
Detail oriented to the point of annoying people because you pick up on things that others don't.
Partial to helping people that are unappreciated, overlooked, and may not have any other types of support.
A solid home/office environment that enables you to get the job done correctly whenever it needs to be done.
Naturally competitive and want to win. YOU want to be the best and enjoy working with others who are the same.
An active LPN license that is in good standing. ****1000 imaginary bonus points if you have long-term care, skilled nursing, assisted living, caremanagement, or other experience working with patients who have chronic conditions.****
At SparroWell, we want to win by helping others get the best care possible. Our awesome team works with physicians, nurse practitioners, and other clinical team members that specialize in taking care of people with chronic illnesses. Our advanced care team also supports patients, families, as well as their caregivers to provide additional resources whenever needed.
On any given day, our team is coordinating care, reviewing medications, auditing charts like a BOSS, collaborating with medical providers, and ultimately making a difference in the lives of patients we serve. We work from home but do occasionally meet in person for meetings and training on the latest requirements/guidelines.
Go ahead, start the conversation by sending us your resume today. We will consider all applicants even though we prefer to work with nurses that have long-term care or post-acute experience. If you would like to learn more about our company, please visit us at **************************** Thank you for reviewing our opportunity and we look forward to hearing from you.
$43k-74k yearly est. 60d+ ago
Work From Home - Manager in Training
Global Elite Texas 4.3
Remote job
We're a fast-growing, tech-driven organization looking for innovative individuals to help take our team to the next level. Typical day-to-day tasks include:• Conducting virtual consultations with clients.• Assessing clients' needs and imparting knowledge on solutions.• Cultivating lasting client relationships through consistent, periodic check-ins.• Completing related administrative tasks (like note taking, appointment setting, etc.) as needed.
Incentives include but not limited to:• No cold calling• Qualified lead program• Advancement based on performance• Weekly pay• Renewals• Mentorship and complete training• Industry leading tools and technology access• Work from home (web conference-based presentations)
Looking for candidates who hold the below characteristics:Passionate. Competitive. Motivated. Dependable. Hardworking. Adaptable. Flexible. Coachable.
Our team consists of all backgrounds and levels of education. We are previous high school graduates, administrative assistants, laborers, veterans, accountants, and so much more!
If you are a hard-working, motivated team player, this may be an opportunity for you!
*All interviews will be conducted via Zoom video conferencing We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
$51k-80k yearly est. Auto-Apply 9d ago
Care Manager - NeuroNav
Pear VC
Remote job
Do you dream of a role where you can connect with people and transform lives - all while working remotely?
We're looking for CareManagers who thrive on building relationships with families with adult neurodivergent children - understanding their goals and helping them access specialized resources. Join us and transform the lives of hundreds of adults with developmental disabilities as you scale with a high-growth, innovative company.
At NeuroNav, we believe everyone deserves the opportunity to make their own choices and shape their story, regardless of disability. Our mission is to enhance the quality of life for adults with developmental disabilities through simplicity and choice. We specialize in helping families navigate a specific California state funded program called Self-Determination, which offers more creative and custom choice as to how to leverage state funds.
This is a life-changing program and you will be the conductor, breaking down barriers for your client and ensuring his or her success. As one of our virtual CareManagers (the heart and soul of our team called “Navigators” internally), you'll create custom client plans and guide families in a step-by-step process to enter and maintain participation in this program. In this remote role, you will be able to leverage your creativity, kindness and relational skills in social work, case management, and service coordination to transform your clients' lives and help them write the stories they dream of.
About NeuroNav
Founded at Stanford in 2020, with support from the Stanford Innovation Fellowship, Pear VC and Core Innovation Capital, NeuroNav drives new vision and change in disability by creating personalized care plans and connecting our neurodivergent clients with virtual Care Navigators who help manage their benefits. Last year, we supported hundreds of individuals in accessing life-changing services, and we're on track to quadruple our impact next year.
Responsibilities include:
Person-centered Planning - you will be trained in a special facilitation framework to capture your client's unique strengths, goals, needs and desired outcomes and align them to a plan unique to them.
Budget & Spending Management - you will help translate personalized plans into concrete support needs and advocate for those needs to local budget authorities.
Project Management - you will be the driver that holds the process together and guides the client and other partner organizations.
Service Provider Access - you will leverage NeuroNav's proprietary resources to search for and assist providers in implementing person-centered plans throughout the year.
Special Projects - you will contribute your talent and insights from working with clients into key company strategy and initiatives each quarter.
What You'll Bring
Bachelor's Degree or equivalent work experience
Social Work or case management experience in the disability or social services field
Client-facing experience managing multiple relationships at one time
Excellent written and verbal communication skills
Must have computer, reliable high-speed internet connection, and a quiet work environment
Fluent in Spanish and bilingual (strongly preferred)
Experience in a performance-based culture with metrics attainment goals (preferred)
Experience serving in the developmental disability field (preferred)
Experience with Microsoft Office & Google Suite (preferred)
Experience in person-centered planning and in the California developmental disability system (preferred)
Experience in Case management: 2 years (Preferred)
Benefits
We believe in supporting our employees' well-being and work-life balance as part of our culture and offer the following benefits:
Remote first - Ability to work from home
Health, vision and dental insurance
401(k)
14 Paid Time Off (PTO) days per year
7 sick or flex days per year
Annual company retreat
Salary: $50-60k per year (depending on experience)
$50k-60k yearly Auto-Apply 60d+ ago
Care Manager - KY
Right Medical Staffing
Remote job
This position consists of weekly in-person CareManagement visits with the client, coordination with PCP and telephonic contact to ensure adherence to treatment plan. Also must be available to answer questions that the client may have between visits. During the visit CM will gather information and educate the patient on his or her disease management, medication administration, and home safety in order to the client remain safely at home. CM will assist patient and/or family member to connect with other needed resources such as meals, transportation to PCP, and insuring that all prescribed medications are in the home. At all times the Director of Healthcare Operations is available as a resource to CM.
Requirements
Must have at least 1 year verifiable experience as a RN, LPN or Social Worker
Must have an active professional license in your state.
Must have a good driving record, auto insurance, a reliable vehicle
Must have internet access for visit and assessment logging
Must be a dependable person
The applicant must not have Disciplinary Actions against their professional license or be listed in the List of Excluded Individuals/Entities Search
Responsibilities
The RN, LPN or Social Worker will also be required to enter all assessment and visit information into the online system within 24 hours of the visit. Upon hire and prior to the first visit, a short online training session and webinar will need to be completed. You will be required to visit the client once a week, 4 times a month on going. Flexible schedule. Work from home.
$51k-92k yearly est. 60d+ ago
Care Manager
Wealthy Group of Companies
Remote job
We are a rapidly growing healthcare organization dedicated to supporting patients living with chronic conditions. Our mission is to deliver personalized, high-quality care that empowers individuals to take control of their health with confidence. Through a fully remote model, our CareManagers guide patients through their care journeys-educating, advocating, and coordinating support that leads to better outcomes and smoother day-to-day management.
We're looking for a motivated CareManager who is eager to apply their medical knowledge in a hands-on, patient-facing role. This position is ideal for someone with a healthcare diploma, training, or any form of medical education or clinical exposure who wants to put that foundation to meaningful use. You'll act as the central point of contact for patients, helping them understand their conditions, navigate care plans, and stay on track with treatment while working alongside providers, social workers, and community partners.
Key Responsibilities:
Monitor and coordinate care plans by tracking progress, adjusting interventions, and maintaining consistent patient support.
Provide clear, accessible education about chronic conditions, treatment options, and lifestyle strategies.
Coordinate appointments, follow-ups, and referrals, ensuring smooth connection to appropriate providers.
Maintain accurate patient records, including health information, insurance details, and supporting documentation.
Respond promptly and empathetically to patient questions, concerns, and urgent needs.
Partner with care teams to develop, assess, and refine patient-centered interventions.
Collaborate with behavioral health, disease management, home health, social work, and community organizations for holistic care.
Ideal Qualities and Skills:
Strong verbal and written communication skills and the ability to simplify medical information for patients.
Fluency in Spanish (spoken and written), with the ability to support Spanish-speaking patients and families.
Solid problem-solving instincts and a proactive approach to anticipating patient needs.
Organized, detail-oriented, and reliable in managing patient caseloads and documentation.
Comfortable prioritizing tasks and managing time effectively in a remote environment.
Collaborative mindset with genuine care for patient well-being.
Healthcare diploma or equivalent preferred. Any level of medical or healthcare experience-clinical rotations, internships, coursework, or similar-is welcomed.
Compensation:
Competitive hourly rate of $15-$20 per hour, based on experience and qualifications (Full Time).
A supportive remote environment with opportunities for professional growth and development.
Fully Remote opportunity.
$15-20 hourly Auto-Apply 60d+ ago
Care Manager - LP (Rockingham County, NC)
Vaya Health 3.7
Remote job
LOCATION: Remote - must live in or near Rockingham County, North Carolina. The person in this position is required to maintain residency in North Carolina or within 40 miles of the NC border. This position requires travel.
GENERAL STATEMENT OF JOB
The CareManager Licensed Professional (“CareManager - LP”) is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (“members”) to ensure that these individuals receive appropriate assessment and services. The CareManager - LP works with the member and care team to identify and alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services needed by the member across the MH, SU, intellectual/ developmental disability (“I/DD”), traumatic brain injury (“TBI”) physical health, pharmacy, long-term services and supports (“LTSS”) and unmet health-related resource needs networks. CareManager - LP supports and may provide clinical transition planning assistance to state, and community hospitals and residential facilities and track individuals discharged from facility settings to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations, including members' home communities. The CareManager - LP also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. The CareManager - LP also utilizes licensed clinical knowledge and skills to assess needs, inform care planning development, provide clinical consultation, and offer recommendations for appropriate care.
As further described below, essential job functions of the CareManager - LP includes, but may not be limited to:
Utilization of and proficiency with Vaya's CareManagement software platform/ administrative health record (“AHR”)
Outreach and engagement
Compliance with HIPAA (Health Insurance Portability and Accountability) requirements, including Authorization for Release of Information (“ROI”) practices
Performing Health Risk Assessments (HRA): a comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas to ensure a whole person approach to care
Adherence to Medication List and Continuity of Care processes
Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing caremanagement
Transitional CareManagement
Diversion from institutional placement
This position is required to meet NC (North Carolina) Residency requirements as defined by the NC Department of Health and Human Services (“NCDHHS” or “Department”). This position is required to live in or near the counties served to effectively deliver in-person contacts with members and their care teams.
ESSENTIAL JOB FUNCTIONS
Clinical Assessment, Care Planning, and Interdisciplinary Care Team:
Ensures identification, assessment, and appropriate person-centered care planning for members.
Links members with appropriate and necessary formal/ informal services and supports across all health domains (i.e., medical, and behavioral health home)
Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs.
Administers the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings based on member's needs. The CareManager - LP uses these screenings to provide specific education and self-management strategies as well as linkage to appropriate therapeutic supports.
The assessment process includes reviewing and transcribing member's current medication and entering information into Vaya's CareManagement platform, which triggers the creation of a multisource medication list that is shared back with prescribers to promote integrated care.
Supports the care team in development of a person-centered care plan (“Care Plan”) to help define what is important to members for their health and prioritize goals that help them live the life they want in the community of their choice.
Ensure the Care Plan includes specific services to address mental health, substance use, medical and social needs as well as personal goals
Ensure the Care Plan includes all elements required by NCDHHS
Use information collected in the assessment process to learn about member's needs and assist in care planning
Ensure members of the care team are involved in the assessment as indicated by the member/LRP and uses clinical skills to evaluate and incorporate other available clinical information into the assessment as necessary
Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions
Uses clinical skills and expertise to review clinical assessments conducted by providers to ensure all areas of the member's needs are addressed. CareManager - LP reviews for clinical accuracy and may provide consultation and technical support to providers as needed based on reviews.
Interprets and analyzes clinical assessments to draw clinical conclusions to support caremanagement activities.
Engages with provider clinical staff to determine clinical appropriateness and course of action when assessments present a wide array of treatment options and members present with complex needs.
Helps members refine and formulate treatment goals, identifying interventions, measurements, and barriers to the goals
Ensures that member/legally responsible person (“LRP”) is/are informed of available services, referral processes (e.g., requirements for specific service), etc.
Provides information to member/LRP regarding their choice of service providers, ensuring objectivity in the process
Works in an integrated care team including, but not limited to, an RN and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP could decide who they want involved
Supports and may facilitate care team meetings where member Care Plan is discussed and reviewed
Solicits input from the care team and monitor progress
Ensures that the assessment, Care Plan, and other relevant information is provided to the care team
Reviews assessments conducted by providers and consult with clinical staff as needed to ensure all areas of the member's needs are addressed
Provide clinical assessment in situations where the member's lack of clinical home or available network provider creates significant risk to member well-being (e.g., need for time sensitive placement/ discharge from inpatient setting)
Updates Care Plans and CareManagement assessment at a minimum of annually or when there is a significant life change for the member
Supports and assists with education and referral to prevention and population health management programs.
Works with the member/LRP and care team to ensure the development of a CareManagement Crisis Plan for the member that is tailored to their needs and desires, which is separate and complementary to the behavioral health provider's crisis plan
Ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques.
Provides crisis intervention, coordination, and caremanagement if needed while with members in the community.
Supports Transitional CareManagement responsibilities for members transitioning between levels of care
Coordinates Diversion efforts for members at risk of requiring care in an institutional setting
Consults with caremanagement licensed professionals, caremanagement supervisors, and other colleagues as needed to support effective and appropriate member care.
Collaboration, Coordination, Documentation:
Utilizes advanced knowledge in their work which requires use of their advanced degree and licensure to be able to participate and initiate independent decisions with matters of significance and drive positive clinical outcomes for Vaya members.
Executes independent discretion and engages in business decisions for the Vaya CareManagement Department that support initiatives to promote Vaya's integrated, whole-person care model for members.
Serves as a collaborative partner in identifying system barriers through work with community stakeholders.
Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate.
Works in partnership with other Vaya departments to identify and address gaps in services/ access to care within Vaya's catchment.
Participates in cross-functional clinical and non-clinical meetings and other projects as needed/ requested to support the department and organization.
Participates in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CMs (CareManager) and receiving support and feedback regarding CM interventions for clients' medical, behavioral health, intellectual /developmental disability, medication, and other needs.
Participates in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and CareManagementleadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system.
Monitors provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards.
Ensures the health and safety of members receiving caremanagement, recognize and report critical incidents, and escalate concerns about health and safety to caremanagementleadership as needed.
Supports problem-solving and goal-oriented partnership with member/LRP, providers, and other stakeholders.
Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues.
Supports and assists members/families on services and resources by using educational opportunities to present information.
Verifies member's continuing eligibility for Medicaid, and proactively responds to a member's planned movement outside Vaya's catchment area to ensure changes in their Medicaid county of eligibility are addressed prior to any loss of service.
Proactively and timely creates and monitors documentation within the AHR to ensure completeness, accuracy and follow through on caremanagement tasks.
Maintains electronic AHR compliance and quality according to Vaya policy.
Ensures all clinical and non-clinical documentation (e.g. goals, plans, progress notes, etc.) meet all applicable federal, state, and Vaya requirements, including requirements within Vaya's contracts with NCDHHS.
Participates in all required Vaya/ CareManagement trainings and maintains all required training proficiencies.
Participates in Vaya committees, workgroups, and other efforts that require clinical knowledge, as requested, and identified.
Other duties as assigned.
KNOWLEDGE, SKILLS, & ABILITIES
Ability to express ideas clearly/concisely and communicate in a highly effective manner
Ability to drive and sit for extended periods of time (including in rural areas)
Exceptional interpersonal skills and ability to represent Vaya in a professional manner
Ability to initiate and build relationships with people in an open, friendly, and accepting manner
Strong attention to detail and superior organizational skills
Ability to make prompt independent decisions based upon relevant facts.
Well-developed capabilities in problem solving, negotiation, arbitration, and conflict resolution, including a high level of diplomacy and discretion to effectively negotiate and resolve issues with minimal assistance.
A result and success-oriented mentality, conveying a sense of urgency and driving issues to closure
Comfort with adapting and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change
Thorough knowledge of standard office practices, procedures, equipment, and techniques and intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.), and Vaya systems, to include the caremanagement platform, data analysis, and secondary research
Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture, and seeing that the details are covered.
Ability to use higher-level clinical training and licensure to perform clinical assessments, drive positive outcomes for members, support caremanagement colleagues, and offer clinical assistance to providers.
Highly skilled at performing clinical assessments of members and identifying member needs.
Extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) within their scope and have considerable knowledge of the MH/SU/IDD/TBI service array provided through the network of Vaya providers.
Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements are preferred.
Ability to complete and maintain all trainings and proficiencies required by Vaya, however delivered, including but not limited to the following:
BH I/DD Tailored Plan eligibility and services
Whole-person health and unmet resource needs (ACEs, trauma-informed care, cultural humility)
Community integration (independent living skills; transition and diversion, supportive housing, employment, etc.)
Components of Health Home CareManagement (Health Home overview, working in a multidisciplinary care team, etc.)
Health promotion (common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)
Other caremanagement skills (transitional caremanagement, motivational interviewing, person-centered needs assessment and care planning, etc.)
Serving members with I/DD or TBI (understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.)
Serving children (child-and family-centered teams, Understanding the “System of Care” approach)
Serving pregnant and postpartum women with SUD or with SUD history
Serving members with LTSS needs (Coordinating with supported employment resources
Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position.
EDUCATION & EXPERIENCE REQUIREMENTS
Master's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. For incumbents with a Master's Degree in a Human Services Area besides Nursing, one of the following required years of experience:
Serving members with BH conditions:
Two (2) years of experience working directly with individuals with BH conditions
Serving members with LTSS needs
Two (2) years of prior Long-tern Services and Supports and/or Home Community Based Services coordination, care delivery monitoring and caremanagement experience.
This experience may be concurrent with the two years of experience working directly with individuals with BH conditions, an I/DD, or a TBI, described above
For incumbents with a Master's Degree in Nursing, four years of full-time accumulated experience in mental health with the population served is required. Experience can be before or after obtaining RN licensure.
*Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104
Licensure/Certification Required:
Valid licensure required. Acceptable licenses are Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Clinical Social Worker Associate (LCSWA), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Associate (LCMHCA), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), Health Services Professional Psychological Associate (HSP-PA), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Addiction Specialist Associate (LCASA), Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage Family Therapist Associate (LMFTA).
*Due to the multi-disciplinary nature of the LME/MCO business, caremanagers must operate within their scope of practice, and must engage and leverage other disciplines outside of their own training and credentials.
Preferred Work Experience:
Experience working directly with individuals with I/DD or TBI
PHYSICAL REQUIREMENTS
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.
Ability to drive and sit for extended periods of time (including in rural areas)
RESIDENCY REQUIREMENT: The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border.
SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open Until Filled
APPLY: Vaya Health accepts online applications in our Career Center, please visit ******************************************
Vaya Health is an equal opportunity employer.
$35k-45k yearly est. Auto-Apply 59d ago
Chronic Care Manager (Remote - Compact States)
Harriscomputer
Remote job
Please note that this job posting is for an evergreen position and does not represent an active or current vacancy within our organization. We continuously accept applications for this role to build a talent pool for future opportunities. While there may not be an immediate opening, we encourage qualified candidates to submit their resumes for consideration when a suitable position becomes available.
Chronic CareManager
Location: Remote
Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic conditions. We believe every patient with chronic disease deserves consistent check-ins, follow-up, and support.
The position of the Nurse Chronic Care Coordinator, Remote will perform telephonic encounters with patients on behalf of our partners each month and develops detailed care plans within our care plan templates in the electronic health record. This begins as an Independent 1099 Contractor position but offers the potential to reach full-time W2 employment (with employee benefits).
Harris CCM is seeking Nurses to work part-time from their home office while complying with HIPAA privacy laws. You will set your own hours and will not be held to a daily work hour schedule. You will be contracted to work a minimum of 20hrs/wk. Harris CCM wants its team members to have the flexibility to balance their work-life with their home life. Part-time team members will typically need to dedicate an average of 20-30 hours per week to care for their assigned patients. This unique business model allows you to choose what days and what hours of the day you dedicate to care for your patients.
The Care Coordinator will be assigned a patient panel based on skill and efficiency level and is expected to carry a patient panel of a minimum of 100 patients per calendar month. Care Coordinators will be expected to complete encounters on 90 percent of the patients they are assigned.
Harris CCM utilizes a
productivity-based pay structure
and pays $10.00 per completed patient encounter up to 99 encounters/month, $10.25/encounter from 100-149 encounters/month, $12/encounter from 150-199 encounters/month, $14/encounter from 200-249 encounters/month, and $16/encounter for >250 encounters/month. Payment tier increases require 3 months consistency to achieve. A patient encounter will take a minimum of 20 minutes (time is cumulative).
What your impact will be:
The role of the Care Coordinator is to abide by the plan of care and orders of the practice.
Ability to provide prevention and intervention for multiple disease conditions through motivational coaching.
Develops a positive interaction with patients on behalf of our practices.
Improve revenue by creating billable CCM episodes, increasing visits for management of chronic conditions.
Develops detailed care plans for both the doctors and patients. The care plans exist for prevention and intervention purposes.
Understand health care goals associated with chronic disease management provided by the practice.
Attend regularly scheduled meetings (i.e., Bi-Monthly Staff Meetings, monthly one on one's, etc.). These “mandatory” meetings will be important to define the current scope of work.
What we are looking for:
Graduate from an accredited School of Nursing. (LPN, LVN, RN, BSN, etc.)
Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no disciplinary actions noted
A minimum of two (2) years of clinical experience in a Med/Surg, Case Management, and/or home health care.
Hands-on experience with Electronic Medical Records as well as an understanding of Windows desktop and applications (MIcrosoft Office 365, Teams, Excel, etc), also while being in a HIPAA compliant area in home to conduct Chronic CareManagement duties.
Ability to exercise initiative, judgment, organization, time-management, problem-solving, and decision-making skills.
Skilled in using various computer programs
(If you don't love computers, you won't love this position!)
High Speed Internet and Desktop or Laptop computer (Has to be operation system of Windows or Mac) NO Chromebooks
Excellent verbal, written and listening skills are a must.
What will make you stand out:
Quickly recognize condition-related warning signs.
Organized, thorough documentation skills.
Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills.
Clear diction. Applies exemplary phone etiquette to every call.
Committed to excellence in patient care and customer service.
What we offer:
Contract position with opportunity to become a full-time position, to include benefit options (Medical, Dental, Vision, 401K, Life).
Streamline designed technology for your Chronic Care operations
Established and secure company since 1976, providing critical software solutions for many verticals in countries ranging from North America, Europe, Asia, and Australia.
Core Values that unite and guide us
Autonomous and Flexible Work Environments
Opportunities to learn and grow
Community Involvement and Social Responsibility
About us:
For over 20 years GEMMS has been the leader in Cardiology Specific EHR technology. The product was developed in a “living laboratory” of a large Cardiology Enterprise with over 40 physicians in 28 locations. For single physician offices to large cardiovascular centers that include a diagnostic centers, ambulatory surgical center, and peripheral vascular offerings.
When physicians and Administrators evaluate GEMMS ONE, they are often impressed with the vast clinical cardiovascular knowledge content and operational aspects found in GEMMS ONE. GEMMS ONE EHR provides a rich array of functionality spanning the entire cycle of patient care. With everything from a patient portal to e-prescribing to clinical documentation to practice management including cardiovascular specific quality measurements and MIPS patient dashboard. GEMMS ONE EHR System provides all the medical records software tools needed to complete your daily tasks in the most efficient way possible.
GEMMS ONE is a fully interoperable and integrated application that allows “real time” merging of clinical processes and revenue cycle management. It also can seamlessly connect to external revenue cycle management programs that might be used in larger enterprises so that you can get the efficiency of Cardiovascular Clinical workflow while supporting the revenue cycle requirements of larger enterprises. Complying with governmental regulations and payer requirements will be simplified, while enhancing your operational and financial performance.