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Top 50 Medical Case Manager Skills

Below we've compiled a list of the most important skills for a Medical Case Manager. We ranked the top skills based on the percentage of Medical Case Manager resumes they appeared on. For example, 6.9% of Medical Case Manager resumes contained HIV as a skill. Let's find out what skills a Medical Case Manager actually needs in order to be successful in the workplace.

These Are The Most Important Skills For A Medical Case Manager

1. HIV
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high Demand
Here's how HIV is used in Medical Case Manager jobs:
  • Conducted initial and ongoing financial determination for eligibility base on Florida HIV/AIDS Eligibility Procedures Guidelines and Ryan White Patient Care Guidelines.
  • Determined and re-determined eligibility for HIV/AIDS applicants/clients.
  • Educated clients on HIV prevention such as safer sex by using condoms and ensure clients adhere to medications and medical appointment.
  • Work with outreach team to provide HIV and HCV rapid testing and counseling to targeted high risk populations.
  • Work with Community Health Prevention to make sure our clients are not spreading HIV/AIDS by using safe practices.
  • Provide care coordination, service linkage, and patient-centered care for people living with HIV and AIDS.
  • Served as Medical Case Manager for a diverse, Medicaid and Ryan White population living with HIV.
  • Conducted intake, assessment and reassessment for about 200 clients living with HIV/AIDS.
  • Monitored clients HIV treatment to reassess client's need for Medical Case Management.
  • Coordinated of interview for the HIV/Healthy Mothers Healthy Babies Infant Mortality Outreach Program.
  • Provide case management services to the HIV and substance abuse population.
  • Provide high quality medical case management for clients who have HIV/AIDS.
  • Utilized a psycho educational approach with HIV naive clients.
  • Educated clients and family with current HIV/AIDS information.
  • Facilitated an HIV positive support group in Creole.
  • Meet semi-annual application renewal deadlines for HIV/AIDS drug assistance programs for 35+ patients.
  • Conducted HIV testing, pre- and post- test counseling for client and family.
  • Assist clients with completing renewals & enrollments of HIV services (e.g.
  • Complete management of client's (HIV/AIDS positive) psychosocial needs.
  • Attended on-going HIV related trainings related to HIV medications and treatment updates.

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122 HIV Jobs

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2. Treatment Plans
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high Demand
Here's how Treatment Plans is used in Medical Case Manager jobs:
  • Provide case management services and treatment plans for outpatient clients receiving psychotropic medications.
  • Managed medical treatment plans of approximately 20 individuals at any given time.
  • Worked with Social Service Workers and Primary Care Physicians to document treatment plans, addenda, and case management issues.
  • Develop, implement and monitor Integrated Treatment Plans for clients accessing the full range of services at the clinic.
  • Document case management assessments, activity, treatment plans, and resolutions; prepares narrative and statistical reports.
  • Conduct client intakes, assess client needs, and develop individualized treatment plans with collaboration with client.
  • Prepared encounter and verified health benefits, carried out case management functions to support client treatment plans.
  • Utilized harm reduction concepts to reduce risks, create better outcomes and develop treatment plans.
  • Collaborate with the interdisciplinary team to elicit referrals and develop treatment plans with the patient.
  • Train incoming new case workers; while auditing documentations, and treatment plans.
  • Assessed and evaluated treatment plans for medical necessity with my scope of practice.
  • Formulated treatment plans with Integrated Treatment Team (multidisciplinary),.
  • Monitored treatment plans, including return to work plans.
  • Reviewed the doctor's treatment plans for appropriateness.
  • Evaluated and assessed medicals and treatment plans.
  • Develop and implement treatment plans.
  • Evaluate effectiveness of treatment plans.
  • Monitored and evaluated injured workers compliance with treatment plans making recommendations as deemed appropriate for optimum recovery.
  • Completed treatment plans and attended Team Meetings involving the psychiatrist, Case manager, client and therapist for the in/outpatient Services.
  • Assess and coordinate treatment plans for soldiers with medical or dental conditions that have or will result in them being non-deployable.

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316 Treatment Plans Jobs

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3. Patient Care
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high Demand
Here's how Patient Care is used in Medical Case Manager jobs:
  • Participated in daily shift report briefings, effectively communicating with out-going/incoming team members regarding patient care to affect positive health outcomes.
  • Develop, implement and evaluate individualized patient care plans.
  • Supported cross-functional medical teams throughout patient care processes.
  • Provided medical case management to ensure federal standards of HIV patient care are adequate and provides continuum of care.
  • Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.
  • Managed patient care from admission through discharge; conducted medical review for clinical appropriateness and level of care.
  • Supervised and trained in home health care staff on proper techniques used to aid in patient care.
  • Develop patient care plans in coordination with the patient, providers and other disciplines as appropriate.
  • Volunteer for high profile case and promoted safe patient care in the face of news issue.
  • Utilize resources, domestic violence shelters and counseling to assist in patient care and recovery.
  • Served as strong member of multidisciplinary patient care team to assure optimal patient outcomes.
  • Participate in the development and implementation of patient care policies and protocols.
  • Reviewed and assessed total patient care for utilization, and quality assurance.
  • Coordinate the integration of social services/case management functions into the patient care.
  • Monitor all aspects of patient care, including diet and physical activity.
  • Oversee daily operation and patient care on a 28-bed unit.
  • Provided linkage to patient care and needs.
  • Evaluate outcome of patient care.
  • Staff Nurse, West Penn Hospital Employed as a nurse in the ICU/Burn Unit providing patient care.
  • Registered Nurse Provided expert hands-on patient care with a strong customer focus.

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6,129 Patient Care Jobs

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4. Health Care
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high Demand
Here's how Health Care is used in Medical Case Manager jobs:
  • Provided documented assistance in coordinating multidisciplinary health care services and referral activities.
  • Coordinate a service plan goal with the medical provider and the patient to achieve the maximum continuity of health care.
  • Prepare the client to be independent in their health care and management of their life living with their illness.
  • Functioned as a liaison between health care providers, the claimant, his/her family, and the funding source.
  • Remind clients to follow-up with health care professionals as well as renew health care benefits per client anniversaries.
  • Design, develop and implement educational and training programs on human sexuality, health care and related issues.
  • Coordinated care with providers in the community in efforts to meet member's health care needs.
  • Coordinated comprehensive health care, including nutrition, dental, health, and support services.
  • Collaborated with physician and other health care members to ensure patient receiving optimal care.
  • Provided nursing intervention based on assessment of need, consulted with other health care.
  • Achieved successful negotiations on inpatient facilities, home health care, hospice and pharmaceuticals.
  • Conducted medical assessment interviews with clients via phone vital to health care reforms.
  • Provided case management for families with children who have special health care needs.
  • Case managing several of the organization's health care centers.
  • Negotiated rates to better utilize patient's health care benefits.
  • Completed applications for Medicaid and/or Health Care District.
  • Coordinate health care across a clinical continuum.
  • Set up Home Health Care, Home IV Infusion, and Home Therapies (P.T./O.T./S.T.).
  • Coordinated and attended appointments, providing communication with adjustor, employer, health care provider and client in timely manner.
  • Set up Nursing Home transfers and Home Health Care Services as needed Managed insurance-policy coverage for each patient.

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7,721 Health Care Jobs

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5. Appropriate Medical Care
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high Demand
Here's how Appropriate Medical Care is used in Medical Case Manager jobs:
  • Teamed with Claims Supervisors and on-site adjusters to facilitate appropriate medical care, payment of claims, and return to work.
  • Acted as advocate in dealing with medical and social service professionals, ensuring client secured appropriate medical care and community services.
  • Served as patient advocate in obtaining timely and appropriate medical care, and in effectuating a safe, successful return-to-work.
  • Facilitated and recommended treatment plans to assure the appropriate medical care for HIV/AIDS patients.
  • Verify enrollment in medical care, and support enrollment from appropriate Medical care.
  • Coordinate appropriate medical care with providers for injured parties on claims involving medical treatment.

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26 Appropriate Medical Care Jobs

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6. Financial Assistance
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high Demand
Here's how Financial Assistance is used in Medical Case Manager jobs:
  • Determined patient's eligibility for Medical Assistance, Transportation Assistance, and other financial assistance programs and assisted in obtaining benefits.
  • Communicate with fellow Case Managers, Behavioral Health Therapists and Members regarding the outcomes of financial assistance applications.
  • Determined eligibility and facilitated the application process for financial assistance with clients.
  • Administered financial assistance for medical treatment.
  • Maintain proper record maintenance, current and archived, in compliance with HIPAA standards for all financial assistance programs.
  • Developed and assisted clients with financial planning, budget development, and assess need for financial assistance.
  • Assist clients with applications for various services (housing, financial assistance, etc).
  • Provide access to Emergency Financial Assistance as needed to promote and maintain positive health outcomes.
  • Provide assistance in seeking housing, employment, financial assistance and other needed services.
  • Conduct 6-month reviews for recipients of financial assistance.
  • Initiated professional relationships between the client and community resources, particularly in regards to financial assistance and housing support services.
  • Provide access to Direct Emergency Financial Assistance (DEFA), (e.g.
  • Provide access to Emergency Financial Assistance (EFA), (e.g.

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34 Financial Assistance Jobs

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7. Mental Health Services
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high Demand
Here's how Mental Health Services is used in Medical Case Manager jobs:
  • Referred clientele for necessary mental health services and evaluate overall progress.
  • Assisted clients in applying for disability, food stamps, cash assistance, public housing, and mental health services.
  • Provided mental health services and assessments (supportive counseling / group counseling).
  • Provided referrals for housing, employment and mental health services as needed.
  • Refer clients to Mental Health services as needed.
  • Linked clients with health care, mental health services, psychosocial, and other needed services.

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50 Mental Health Services Jobs

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8. Management Services
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high Demand
Here's how Management Services is used in Medical Case Manager jobs:
  • Provide case management services to individuals and families infected/affected with HIV/AIDS.
  • Provided on-site medical case management services for workers' compensation.
  • Provide medical and outreach case management services to homeless individuals.
  • Provided on-site and telephonic medical case management services.
  • Perform utilization and case management services for members with a commercial, Medicare and Medi-Cal managed care health plan.
  • Provide case management services and social work intervention to the families of children with special health care needs.
  • Provide case management services to injured employees under the Bureau of Worker's Compensation program.
  • Provided direct case management services to PLWHA in the clinic and community setting.
  • Provide Case Management Services: Advocate for clients or patients to resolve crises.
  • Provided case management services in accordance with MDPH-HIV Residential Standards of Care.
  • Provided case management services for work related injuries from injury to RTW.
  • Provide case management services to patients receiving medical treatment from HACS.
  • Maintain a caseload of 150 clients under Medical Case Management services.
  • Provided bilingual case management services to clients that are HIV positive.
  • Provide comprehensive case management services for Ryan White eligible patients.
  • Provide clients with comprehensive HIV/AIDS medical and case management services.
  • Assess member's needs for case management services.
  • Performed all telephonic case management services to contracted insurance companies through out country.
  • Conducted psychosocial assessments on clients after 2 months of entering Case Management services and yearly upon entrance date.
  • Provided case management services for insurance company clients of Intracorp.

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1,410 Management Services Jobs

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9. Service Plans
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high Demand
Here's how Service Plans is used in Medical Case Manager jobs:
  • Completed consumer intakes, develop comprehensive service plans and reassessments.
  • Co-developed comprehensive client-centered service plans with clients.
  • Provide Case management to HIV/AIDS patients, Ryan White recipients by completing intakes, assessments and service plans.
  • Provided crisis counseling, completed service referrals for the client as needed and monitored client service plans.
  • Handled case assignments, draft service plans, review case progress, and determine case closure.
  • Conducted intakes, assessments and designed service plans based upon the specific needs of the client.
  • Assessed client's strengths and weaknesses and created an individual long term service plans.
  • Developed comprehensive, individualized service plans which address client's barriers to care.
  • Interviewed parents and clients to complete Family Needs Assessments and Service Plans.
  • Cultivated relationships with clients to develop service plans and broker agency services.
  • Advocated for entitlements, created service plans and ongoing assessments.
  • Develop service plans in conjunction with internal and external providers.
  • Conducted intakes, assessments, and service plans.
  • Develop and manage service plans for individual clients.
  • Provided comprehensive family-centered assessments and service plans of medical, social and psychosocial needs.
  • Documented all assessments, and interventions, and created comprehensive Individualized Service Plans.
  • Developed individual service plans of care ensuring attention to individual needs, including assessing for suicide ideations, and goal setting.
  • Provided documentation to reflect client interaction, outreach attempts, biannual psychosocial assessments and service plans.
  • Assess client's needs to create a treatment/service plans that address client's psychosocial needs.
  • Conduct bio-psychosocial assessment& individualized service plans of clients.

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104 Service Plans Jobs

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10. Community Resources
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high Demand
Here's how Community Resources is used in Medical Case Manager jobs:
  • Conduct medical evaluations, coordinate care including physician referrals, diagnostic imaging, community resources, transportation and other ancillary services.
  • Coordinated post-discharge services including pharmaceuticals, durable medical equipment, and community resources.
  • Researched available community resources and coached clients on contacting and utilizing resources.
  • Provide and coordinate community resources and referrals.
  • Referred families to local community resources.
  • Accessed community resources and services on behalf of clients as needed to promote and maintain positive health and social outcomes.
  • Served as a case manager / patient advocate, coordinating community resources to assist them in maintaining quality of life.
  • Referred client to community resources for substance abuse treatment, shelter and assisted living placement, STS transportation, etc.
  • Establish and maintain contact with community resources to ensure continuity of care (e.g., case managers, conservators).
  • Educate & advocate for and with community resources to support the member s addressed needs.
  • Supported patients in applying for Medicaid and Medicare as well as available community resources.
  • Assessed participant's needs and connected them with available community resources.
  • Taught/reviewed CPR with parent or caregiver and provided with community resources.
  • Work closely with families to coordinate community resources.
  • Assisted in finding community resources for clients.
  • Assist with discharge planning and community resources.
  • Refer clients to available community resources.
  • Facilitate coordination of referrals through Lehigh Valley Health Network and Community Resources.
  • Provide community resources to assist homeless individuals with short and long-term goals (i.e.
  • Conducted extensive Psycho-Social Assessments Collaboratively developed client centered treatment plans Connected clients with needed community resources

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395 Community Resources Jobs

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11. Insurance Companies
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high Demand
Here's how Insurance Companies is used in Medical Case Manager jobs:
  • Conduct Personal Injury Protection (PIP) facility audits for the catastrophically injured and generate comprehensive reports to insurance companies.
  • Conducted medical interviews for insurance companies by reviewing claims and applicant's previous/current medical history.
  • Interacted with patients and insurance companies in order to assure quality patient care and benefits management
  • Conducted medical interviews with applicants/patients for health insurance companies and obtained patient medical histories.
  • Provided medical case management to workers compensation claims referred by various insurance companies.
  • Worked with a variety of insurance companies with individualized policies and procedures.
  • Document cost savings for national insurance companies through effective case management.
  • Serve as a liaison between corporations, insurance companies and medical providers to ensure the patient receives the finest care available.
  • Served as liaison between clients and insurance companies as well as counseling services, physicians, and other outside agencies.
  • Work with others insurance companies, law firms in the evaluations medical legal cases as per requested by the company.
  • Designed and implemented care plan programs to deliver quality care within the regulatory confines of Medicare and insurance companies.
  • Worked with Providers and Insurance Companies to achieve good communication and referrals while problem solving any issues that arose
  • Box 845, Dunbar, WV 25064 Independent Contractor-Examiner Performance of examinations for various insurance companies.
  • Disputed medical claims on behalf of hospitals in Georgia across the nation; against insurance companies.
  • Function as a primary interface with HMO's and insurance companies.
  • Offered complete case management for multiple companies and insurance companies.
  • Conduct health insurance medical risk assessment, improving the manner in which insurance companies acquire and utilize data via multi-software utilization.
  • Consulted with insurance companies on medical issues, and provided recommendations based on injuries and treatment progress.
  • Perform field Case Management for workers' compensation claims for several different insurance companies.
  • Coordinate medical treatment and Return To Work(RTW) for Mississippi state workers compensation insurance companies and clients.

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100 Insurance Companies Jobs

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12. Medical Records
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high Demand
Here's how Medical Records is used in Medical Case Manager jobs:
  • Performed concurrent review of medical records to ensure patient received appropriate medical care and were discharged appropriately.
  • Review individual medical records, make specific recommendations to staff and assure that recommendations are implemented.
  • Managed the transfer of medical records from multiple medical providers into a consolidated medical record.
  • Followed HIPAA regulations regarding patient medical records and confidentiality.
  • Read, analyzed, and interpreted medication lists, medical records, and phone assessments to properly document findings.
  • Maintain patient medical records that include the required elements for compliance with contractual and Ryan White programmatic requirements.
  • Communicated with all members of the treatment team, reviewed all medical records and identified potential problems.
  • Obtain medical records from providers during initial contact and follow up with written correspondence if necessary.
  • Audited medical records and performed claims reviews Client liaison for the insurance company.
  • Review medical records for completeness and files records in designated areas.
  • Maintained patient files and medical records for procedures of HMO members.
  • Request medical records update from care providers every six months.
  • Obtained medical records from hospitals, SNF, or clinic.
  • Obtain medical records for evaluation of treatment.
  • Updated medical Records and EMR.
  • Qualified Professional/Medical Records Analyzed and handled intake forms for various clients.
  • Compiled medical records into Recertification packages for inspection by the Chief Medical Examiner at the FAA Oklahoma campus.
  • Gained experience in EMRs (Electronic Medical Records) and customer service.
  • Obtained medical records telephonically during initial contact and follow up with written correspondence or in person, if necessary.
  • Provide medication oversight Compiles, verifies, types and files medical records from hospitals or other health care facilities.

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285 Medical Records Jobs

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13. Medical Treatment
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high Demand
Here's how Medical Treatment is used in Medical Case Manager jobs:
  • Authorized medical treatment and associated diagnostic testing on assigned claims as allowed by state or policy jurisdictions.
  • Authorize appropriate medical treatment, including certification of hospitalizations and procedures, based on medical data review.
  • Assist insurance carriers with medical management/coordination of medical treatment for workers' compensation claims.
  • Provided telephonic case management on claims involving disability and medical treatment.
  • Facilitated authorization process of medical treatment plan with insurance carrier.
  • Coordinated follow-up of medical treatment.
  • Accessed funding for travel to medical treatment facilities, and educated soldiers on all policies and procedures related to their condition.
  • Coordinate and follow-up with client regarding medical treatment to ensure timely delivery of services, coordinate access and continuity of care.
  • Acted as a liaison between client, medical providers, and pharmacy to assist clients with maintaining medications and medical treatment.
  • Case managed high risk members with complicated medical treatment needs, reported high risk/high dollar cases for reinsurance needs.
  • Coordinate and follow up of multidisciplinary medical treatments and access to services through PAC services.
  • Coordinate and follow-up of medical treatments, that are components of medical case management.
  • Obtain final disposition from Medical Treatment Facility (MTF) and process according.
  • Obtain approval for any medical treatment, procedures or equipment needed.
  • Assist claim handlers in managing medical treatment to an appropriate resolution.
  • Develop care plans including coordination and follow up of medical treatment.
  • Coordinate Medical Treatment provided by staff and local physicians.
  • Performed UR for medical treatment and associated testing.
  • Encouraged client participation in medical treatment.
  • Identify key elements of medical treatment plan through evaluation of diagnosis, symptomology and progress toward return to work.

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40 Medical Treatment Jobs

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14. Substance Abuse
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high Demand
Here's how Substance Abuse is used in Medical Case Manager jobs:
  • Engaged HIV infected patients with medication adherence counseling, adherence to medical visits, substance abuse treatment and mental health treatment.
  • Assist in engagement of clients into substance abuse, mental health and medical treatment, obtaining entitlements and other basic needs.
  • Provide referral and linkages to ancillary services such as pharmacy, mental health, and substance abuse services.
  • Provide referrals for entitlement services, behavioral health and substance abuse treatment as appropriate for identified clients.
  • Provided individualized case management services to individuals diagnosed with HIV/AIDS, Mental Illness and Substance Abuse.
  • Coordinated client care with medical, dental, mental health, substance abuse and other providers.
  • Assisted with the prevention of homelessness, substance abuse, and mental health crisis.
  • Conduct Health and Wellness groups for the department of Behavioral Health Substance Abuse Program.
  • Aided clients in substance abuse counseling as well as health and wellness education.
  • Refer clients for yearly dental, psychiatric, substance abuse & eye examinations.
  • Linked clients to medical care, substance abuse treatment and other community services.
  • Process referrals to medical specialists, behavioral health, and substance abuse services.
  • Completed psycho-socials, including mental health and substance abuse screenings and assessments.
  • Provide direct care for adults with substance abuse and psychiatric disabilities.
  • Address and referred client to substance abuse program if needed.
  • Identify and address barriers to substance abuse recovery.
  • Completed daily intake assessment Provided individual, group counseling to adult men with HIV, substance abuse, and mental health.
  • Identified gaps in care resources, mental health, substance abuse, nutrition, and etc.
  • Case manage clients who are HIV/AIDS+, Mentally Ill and with Substance abuse issues.
  • Referred clients to inpatient/outpatient substance abuse programs and mental health services.

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1,055 Substance Abuse Jobs

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15. Medical Care Providers
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average Demand
Here's how Medical Care Providers is used in Medical Case Manager jobs:
  • Work in conjunction with medical care providers ensuring all clients are case conferenced at medical rounds at least twice per year.
  • Work in conjunction with medical care providers .

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94 Medical Care Providers Jobs

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16. Support Services
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average Demand
Here's how Support Services is used in Medical Case Manager jobs:
  • Provided referrals to internal and external support services.
  • Develop and implement wellness plans, routinely monitor, follow-up and reassess, coordinate health and support services and identify resources.
  • Discharge plan, follow-up services, benefits counseling, implement community support services, housing for optimal support and long-term stability.
  • Assist in coordination of client support services with Community Partners, identification of unmet client needs and problematic needs.
  • Assisted and supported clientele with applying for, accessing, and adhering to core medical and support services.
  • Perform assessments to determine program eligibility for case management, medical, and other support services.
  • Assist in coordination of client support services, identification of unmet client needs and programmatic needs.
  • Provided counseling, case management and support services to children and young adults with special needs.
  • Provide comprehensive case management and support services to 80-85 individuals infected with or affected by HIV/AIDS.
  • Perform intake and assessments for support services and housing needs for homeless individuals.
  • Meet objectives for the provision of referrals and linkages to support services.
  • Linked client to support services and resolved access problems.
  • Provided assessment and support services to HIV/AIDS clients.
  • Work collaboratively with multi-disciplinary team to coordinate support services to clients.

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448 Support Services Jobs

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17. Utilization Review
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average Demand
Here's how Utilization Review is used in Medical Case Manager jobs:
  • Impacted CorVel's ability to secure utilization review business by providing quality on-site customer service and education.
  • Review and evaluate all medical treatment to determine appropriateness by way of utilization review.
  • Coordinated communication with physicians and Utilization Review Departments to obtain medical information.
  • Monitor Physical therapy - Utilization review for Physical therapy if appropriate.
  • Determined medical necessity of treatment requests through the Utilization Review process.
  • Completed Medical Case Management programs and Utilization Review program.
  • Conduct in-house utilization reviews for coordination of care department.
  • Implemented and performed monthly self-reviews for Utilization Review.
  • Perform Utilization Review according to established guidelines.
  • Implemented Utilization Review per business protocols.
  • Performed utilization review, prior-authorizations and rate negotiations for health care services and equipment, and submitted monthly progress reports.
  • Performed utilization review of procedures, and inpatient hospital stays * Maintained audit compliance.
  • Trained 17 assigned staff in California Utilization review process.
  • Perform utilization review on a daily basis.
  • Utilize Cerner to review patients' clinical information for submission and utilization review.
  • Send clinical for Utilization review to insurance companies and update certifications on Midus.
  • Complete utilization review on treatments/medical care in an appropriate timeframe.
  • Perform utilization reviews and conduct multi-disciplinary rounds.
  • March of 1996 Palms West Hospital in our division to agree to use the Utilization Review module the Meditech system.
  • Perform utilization review according to guidelines and obtain medical records from providers telephonically.

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1,127 Utilization Review Jobs

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18. Medical Conditions
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average Demand
Here's how Medical Conditions is used in Medical Case Manager jobs:
  • Performed vital sign collections and assessed resident's medical conditions to determine if further medical attention was warranted.
  • Provide health education regarding acute and chronic medical conditions and disabilities.
  • Scheduled physicals and prepared all related paperwork concerning medical conditions.
  • Maintained a caseload of indigent patients with complex medical conditions.
  • Obtain medical history for specific claimed medical conditions.
  • Performed underwriting, and auditing, tasks in order to make decisions based on medical conditions disclosed on medical insurance applications.
  • Work with refugees with serious medical conditions and ensure all appointments, medications, and other health care needs are met.
  • Educated in the latest advances of drugs, medical conditions and their associated treatments, and medical terminology.
  • Track medical conditions, treatments and various factors for the grant reports that support our services.
  • Monitor medical conditions of clients and conduct home visits, as needed.
  • Educated Clients on medical conditions, and medications.
  • Obtained patients' medical history Assessed and described medical conditions Consulted with patients over the phone in regards to their medical status

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8 Medical Conditions Jobs

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19. Intake Assessments
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average Demand
Here's how Intake Assessments is used in Medical Case Manager jobs:
  • Completed intake assessments to determine eligibility for the program.
  • Conduct Intake Assessments and Individualize Service Plan (ISP) to members on caseloads.
  • Coordinated all telephone screenings and complete all intake assessments; developed service plans.
  • Completed intake assessments on clients coming in to agency for first time.
  • Complete intake assessments for program enrollment and service plan development.
  • Completed intake assessments for new clients.
  • Completed intake assessments with patients and drafted community re-entry plans following treatment.

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47 Intake Assessments Jobs

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20. Appropriate Referrals
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average Demand
Here's how Appropriate Referrals is used in Medical Case Manager jobs:
  • Make appropriate referrals to existing community agencies for additional support services.
  • Facilitated appropriate referrals to alternate or supplemental providers as needed.
  • Identify and make appropriate referrals to available assistance programs.
  • Facilitate appropriate referrals to appropriate agencies or programs.
  • Make appropriate referrals to the Hope and Help Center s services and other social or professional service agencies.
  • Coordinate local, State, and Federal resources, including appropriate referrals to Government and Non-Government Agencies.
  • Provided assessments, wrote care plans and goals; made appropriate referrals for additional services.
  • Make appropriate referrals to service providers for supportive services, housing programs and benefits assistance.
  • Make appropriate referrals within the agency and in the community as needed.
  • Make appropriate referrals and consultations in and outside the agency.
  • Provided HIV rapid tests and made appropriate referrals as needed.
  • Make appropriate referrals and link clients to other appropriate resources.
  • Make appropriate referrals and linkages to treatment and support services.
  • Updated comprehensive service plans, made appropriate referrals for clients.

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289 Appropriate Referrals Jobs

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21. Medical Appointments
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average Demand
Here's how Medical Appointments is used in Medical Case Manager jobs:
  • Monitor care by attending medical appointments to ensure compliance with recommendations.
  • Provided transportation arrangements to and from medical appointments.
  • Schedule and attend medical appointments providing translation.
  • Accompanied clients to infectious disease medical appointments.
  • Monitored the injured employee's medical appointments outcomes and progress towards full duty return to work eliminating or minimizing lost time.
  • Assessed and identified consumer social service needs that may interfere with their ability to adhere to medical appointments and medications.
  • Attend to medical appointments with members to assure quality of care and to have a better outcome.
  • Organize transportation and medical appointments, including crisis, support for members and their families.
  • Process orders for Soldiers traveling to medical appointments using Defense Travel System (DTS).
  • Attended injured workers medical appointments and evaluated injured worker's progress to return to work.
  • Accompanied clients to medical appointments and participated in discussions concerning the client's medical progress.
  • Assist clients with obtaining primary, specialty, and other medical appointments.
  • Performed home visits and also attended clients' medical appointments.
  • Attend medical appointments with clients acting as a client advocate.
  • Attend medical appointments to ensure quality of care and compliance.
  • Remind patients on case load of upcoming medical appointments.
  • Schedule medical appointments and assist on PHA events.
  • Follow up with client's medical appointments.
  • Attend medical appointments with clients.
  • Monitor patients health status, compliance with medical appointments, and adherence to medication regimens.

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10 Medical Appointments Jobs

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22. Medical Management
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average Demand
Here's how Medical Management is used in Medical Case Manager jobs:
  • Coordinated medical management and vocational rehabilitation.
  • Processed and managed worker's compensation medical claims; calculated benefits and established cost-effective medical management protocols based on prognosis.
  • Market the case management/medical management program to military treatment facility physicians, to include education and in-services.
  • Develop medical management strategy and give the provider information necessary to facilitate a return to work plan.
  • Provided medical management and vocational rehabilitation counseling and case management services to hospital system patients and employees.
  • Have developed excellent professional relationships with Medical Clinic staff, and with community medical management staff.
  • Developed the medical management department, and identified our preferred provider network.
  • Implemented training and education to other medical management team members.
  • Reviewed and edited all medical management reports submitted to clients.
  • Monitor all medical management lock-in members.
  • Worked as an independent/medical management consultant for Rehabilitation Management, Inc., the company I presently work for.
  • Conducted medical management processes; liaison for employer groups; prepared outcome reports; participated in wellness programs.
  • Work closely with and assist the Nurse Case Manager in the provision of medical management services.
  • Completed transplant CM training and maintained transplant case load under CoverTN Medical Management.
  • Utilize M & R Criteria as a guideline when evaluating appropriate medical management.
  • Utilized medical management guidelines to coordinate care and services through the continuum.
  • Complete the Health Risk Assessment in the medical management software system.
  • Teamed with claims adjustors for facilitation of appropriate medical management post bodily injury via effective communication with Doctors/Providers/ Employers/Attorneys.
  • Key Highlights Consistently exceeded all expected accuracy targets for billing and medical management year over year.
  • Provided medical management and job placement services to clients assisting them to reach a pre-injury/pre-illness level of function.

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714 Medical Management Jobs

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23. Treatment Adherence
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average Demand
Here's how Treatment Adherence is used in Medical Case Manager jobs:
  • Utilized motivational interviewing, CBT, and other empowerment-based interventions to increase treatment adherence among at-risk populations.
  • Conduct counseling around medication management, treatment adherence, and risk-reduction education.
  • Update providers of issues of medical case management including treatment adherence counseling.
  • Provided Treatment adherence counseling/education to patients.
  • Monitor client progress including tracking viral load and CD4 count, maintaining dialogue with the physicians and providing treatment adherence information.
  • Educated clients about HIV/AIDS, to include transmission, prevention, treatment adherence, viral load, and CD4 count.
  • Referred and link clients to appropriate services within the system of care that promotes treatment adherence and greater self-sufficiency.
  • Lead facilitator of a monthly HIV Treatment Adherence Group and bi-weekly Interpersonal Relationships Group which holds 10-20 clients.
  • Coordinate medical services, referral to medical care, education, and treatment adherence counseling to HIV+ patients.
  • Implemented the medical treatment plan by providing counseling on medication, appointment and other treatment adherence issues.
  • Coordinated treatment adherence, risk reduction and nutritional support, tools and counseling for all clients.
  • Provided clinical interventions to address mental health and substance abuse barriers to HIV treatment adherence.
  • Provide treatment adherence counseling to ensure readiness for, and adherence to complex HIV/AIDS treatments.
  • Educate clients (children & adults) on treatment adherence, through group workshops.
  • Provided HIV treatment education, treatment adherence skills, health and wellness education.
  • Provided treatment adherence counseling to promote client meeting medical goals.
  • Monitor treatment adherence and address any treatment barriers.
  • Create and review treatment adherence activities with clients.
  • Provide treatment adherence/ treatment education through facilitating interventions and support group (i.e.
  • Provide counseling on appointments, medication and treatment adherence .

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24. Social Workers
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average Demand
Here's how Social Workers is used in Medical Case Manager jobs:
  • Interviewed patient's to determine specific needs for a safe return home, coordinated discharge plans collaboratively with hospital social workers.
  • Coordinated admission to host facility while collaborating with hospital case managers, social workers, insurance case managers and families.
  • Network with community social workers and related agencies to stay informed about and implement best practice.
  • Collaborated with on site social workers/case management team to provide care for HIV positive individuals.
  • Act as liaison with medical providers, social workers and family as needed.
  • Work with Social Workers to set up aftercare for patients and discharge.
  • Assist Social workers in discharge planning.
  • Care conferences and intake meetings with clients, RNs, and Social Workers.

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46 Social Workers Jobs

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25. Medical Services
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average Demand
Here's how Medical Services is used in Medical Case Manager jobs:
  • Managed and coordinated comprehensive medical services of the injured individual on behalf of industrial and liability insurance companies.
  • Coordinated therapy, medical services and often second opinions to minimize medical expense for insurance carrier.
  • Negotiate directly with physicians regarding treatment plans and coordination of medical services for optimal outcomes.
  • Facilitated medical services for medically fragile children in various foster care programs.
  • Coordinate necessary and reasonable medical services for injured worker.
  • Coordinate and integrate behavioral health and medical services.
  • Negotiated medical services and durable medical equipment costs.
  • Monitored quality and effectiveness of medical services.
  • Coordinated medical Services for all Residents.
  • Provided referrals to clients seeking community resources in housing, financial, transportation, nutrition, mental/substance treatment and medical services.
  • Educated clients regarding various community resources such as housing, employment, nutrition, mental health and medical services.
  • Facilitate linkages and referrals to maintain the clients' involvement with their primary medical services.
  • Provided coordination of medical services for workers' compensation claims with cost containment in mind.
  • Assisted in connecting clients with appropriate medical services, insurance coverage and community resources.
  • Coordinated medical services, follow up appointments and referrals for large caseload.
  • Updated client medical services with doctors, nurses, and pharmacies.
  • Connect clients with medical services, both insured and non-insured.
  • Handle the coordination off all medical services HIV and Non-HIV.
  • Assisted patients in reaching pre-injury status or MMI and coordinated needed medical services while maintaining open communication with all parties involved.
  • Coordinated medical services, attended appointments and updated payors.

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40 Medical Services Jobs

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27. Crisis Intervention
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average Demand
Here's how Crisis Intervention is used in Medical Case Manager jobs:
  • Perform initial comprehensive case management assessment and develop a plan of intervention that addresses identified need for crisis intervention.
  • Provide crisis intervention and consultation/outreach to community agencies.
  • Provide crisis intervention and group facilitation as needed.
  • Provided crisis intervention with a national company.
  • Managed caseload of 20 clients, provided client advocacy, referrals to community resources, and crisis interventions when needed.
  • Provided case-management services to patients as needed: provided counseling, resource referral, advocacy, and crisis intervention.
  • Provide crisis intervention as needed inclusive with assessing and identifying client needs for supportive services on an ongoing basis.
  • Provide crisis intervention, medical case management, and referral services to clients with HIV/AIDS
  • Used expertise in crisis intervention, psychiatric evaluation, and substance abuse assessment.
  • Ensured that 24-hour crisis intervention information was available and easily accessible to clients.
  • Covered on call for hospital social services to assist in crisis intervention.
  • Provided counseling support and crisis intervention for clients as appropriate.
  • Conduct home visits, education, and on-site crisis intervention.
  • Perform intake Discharge planning and Crisis Intervention for clients.
  • Provide crisis intervention to patient as needed.
  • Provided client support and crisis interventions.
  • Conduct psychosocial assessments, crisis intervention and coordinate outside referrals for families.
  • Implement crisis intervention /de-escalation methods as needed.
  • Develop and implement individual service plans, crisis intervention, and on-going reassessment of service plans.
  • Conducted bio-psychosocial assessments; crisis intervention, primarily responsible for providing services to clients who are HIV positive.

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210 Crisis Intervention Jobs

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28. Medical Necessity
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average Demand
Here's how Medical Necessity is used in Medical Case Manager jobs:
  • Advised on coverage and medical procedure authorization from a medical perspective based on medical necessity in an emergency setting.
  • Review of medical necessity and hospital utilization, with recommendations to the Medical Director or Employer Group Benefit Administrator.
  • Review of medical necessity and hospital utilization, with recommendations to Medical Director and some claims review.
  • Reviewed and authorized outpatient/inpatient, acute rehabilitation and home health care services according to medical necessity.
  • Perform medical review, case management, medical necessity, and utilization management
  • Investigate claims to determine medical necessity verses cosmetic procedure.
  • Evaluate treatment plans for appropriateness or medical necessity.
  • Determine causality and medical necessity, etc.
  • Tasked with authorizing medical treatment, determining medical necessity of treatment, cost containment and review of long term disability files.
  • Review referral requests for medical necessity, referring to the Clinical Manager for those that require additional expertise.
  • Make clinical decisions based on medical necessity to approve requested health services for these patients.
  • Evaluate the medical necessity and appropriateness of care, optimizing patient outcomes.
  • Assess all admissions for medical necessity and appropriate level of care.
  • Review patient cases for medical necessity and authorize continuing patient care.
  • Identified cost-effective care, reviewed all cases for medical necessity.
  • Reviewed cases to determine medical necessity and applied Milliman-Robertson guidelines to pre- certify level of care.
  • Home visit assessments to determine medical necessity Utilization Management for private duty home health services.
  • Reviewed and analyzed pre-determinations and supporting documentation to determine medical necessity of service.
  • Performed onsite admission and concurrent reviews for medical necessity.
  • Refer current medication list to Physician Advisor, Peer or Pharmacy Review for medical necessity, appropriateness and weaning protocol.

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834 Medical Necessity Jobs

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29. Durable Medical Equipment
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Here's how Durable Medical Equipment is used in Medical Case Manager jobs:
  • Negotiated case specific rates for extended services such as rehabilitation, skilled nursing, home health and durable medical equipment.
  • Arranged home visits with skilled nursing staff, obtained durable medical equipment to assist with patient's needs.
  • Promote use of cost efficient vendors for diagnostics, supplies and durable medical equipment.
  • Assist patients of the Clinic with needed DME (Durable Medical Equipment).
  • Coordinate appointments, referrals, durable medical equipment, and transportation.
  • Precerted and case managed home health disciplines, home infusion and durable medical equipment for HMO and PPO lines of service.

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191 Durable Medical Equipment Jobs

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30. Customer Service
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low Demand
Here's how Customer Service is used in Medical Case Manager jobs:
  • Involved in facility quality improvement process by identifying customer service issues and aiding in resolution.
  • Utilized customer service while gaining more knowledge in pharmaceuticals and medical procedures.
  • Supervised telephone customer service personnel in a call center environment.
  • Provided excellent customer service and case management services.
  • Entrusted with the most complex customer service issues as a result of exceptional ability to promptly resolve concerns and satisfy applicants.
  • Facilitated staff meetings, coordinated case manager workloads, conducted case staffing sessions, and resolved escalated customer service issues.
  • Provide customer service with a clear vision of our company's products and goals to exceed our customer's expectations.
  • Utilize strong communication, customer service, and team building skills to collaborate and communicate with team members and clients.
  • Coordinate and follow-up on medical care and return to work objectives while maintaining quality customer service in high-pressure situations.
  • Provided clients with medical case management, supportive counseling and psycho education as well as excellent customer service.
  • Evaluated patients for health insurance, providing excellent customer service; interacted with a variety of Insurance companies.
  • Assisted agents and human resource managers to optimize customer service experience for their clients and employees.
  • Provide customer service, and determined if clients are eligible for the program using program protocols.
  • Managed reviews, complaints, internal audits; Customer Service in multiple departments.
  • Obtained communication skills as well as superior customer service skills.
  • Provided premier customer service to members and providers.
  • Obtained health and prescription information for Blue Cross Blue Shield from HCR enrollees, provided patient education and outstanding customer service.
  • Streamlined front office procedures to improve customer service,intake efficiencies and communication between reception, medical records and clinical staff.

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15,703 Customer Service Jobs

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31. Risk Reduction
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low Demand
Here's how Risk Reduction is used in Medical Case Manager jobs:
  • Led project to create patient-targeted brochures containing information to educate on risk reduction.
  • Provided HIV risk reduction education and prevention
  • Conducted risk reduction counseling and partner counseling and provide referral services (PCRS) with all clients to prevent HIV transmission.
  • Provided risk reduction materials, safer injecting education, and substance abuse counseling to members of the Syringe Access Program.
  • Assisted clients in completing patient assistance applications for medications, taught sex education and risk reduction to clients.
  • Attend middle and high schools teaching youth about sex education, risk reduction and preventative measures.
  • Provided HIV/HCV testing services, risk reduction counseling, substance abuse counseling and referrals to clients.
  • Provided partners of HIV + clients with HIV/AIDS education and risk reduction strategies.
  • Conducted group-counseling sessions on HIV, positive behavior skills building and risk reduction.
  • Provided risk reduction counseling to help stop the spread of sexually transmitted diseases.
  • Provided HIV prevention material, risk reduction counseling to the targeted population.
  • Developed care plans, risk reduction plans and relapse prevention plans.
  • Provide information and resources on health promotion and risk reduction methods.
  • Provide support and counsel HIV-positive clients on risk reduction plans.
  • Provide risk reduction counseling and access to harm reduction materials.
  • Provided on-going education, positive behavior skills building and risk reduction.
  • Engaged clients in risk reduction and behaviour change strategies.

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9 Risk Reduction Jobs

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32. Medication Adherence
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low Demand
Here's how Medication Adherence is used in Medical Case Manager jobs:
  • Monitored client's medication adherence and initiated referrals to nursing appointments for medication boxes when appropriate.
  • Conduct Medication Adherence Education/counseling for patients who have medication adherence problem as needed.
  • Provide HIV/AIDS education and medication adherence.
  • Conduct quarterly medication adherence follow up for each STAR Clinic patient who is on HIV medications.
  • Collaborate with the client and provider to establish access to primary medical care and medication adherence.
  • Reviewed medical labs to monitor client CD4 counts and viral loads to ensure medication adherence.
  • Educated clients on the HIV Life cycle and on Medication adherence every 90 days.
  • Assisted patients with improved medication adherence, visit adherence, and overall health status.
  • Informed client about the importance's of medication adherence and yearly screenings.
  • Educated client's on the HIV/AIDS Life cycle; discussed medication adherence.
  • Educate on medication adherence and transmission prevention using the harm reduction model.
  • Assist clients with medication adherence.

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33. Care Coordinator
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low Demand
Here's how Care Coordinator is used in Medical Case Manager jobs:
  • Developed and implemented patient-centered medical home/Embedded Care Coordinator Program for BlueCare and TennCare Select.
  • Post Acute Care Coordinator for in-patient rehabilitation unit

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229 Care Coordinator Jobs

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34. Support Groups
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low Demand
Here's how Support Groups is used in Medical Case Manager jobs:
  • Served as a member of the interdisciplinary health team; Collaborated with departmental/organizational support groups.
  • Facilitated and coordinated educational support groups for clients.
  • Coordinated and facilitated on-site support groups.
  • Facilitated weekly social support groups.
  • Organize support groups or counsel family members to assist them in understanding, dealing with, and supporting the patient.
  • Facilitate weekly support groups to discuss side effect management, adverse reactions and community stigma for HIV positive clients.
  • Assisted in the development and implementation of workshops, support groups, and presentations for program participants.
  • Liaised with community support groups and social service systems to accommodate special needs members.
  • Provide health education by coordinating support groups for clients and medical staff.
  • Facilitated support groups focused on healthy living for youth living with HIV/AIDS.
  • Advise clients of opportunities such as HIV Support Groups and retreats.
  • Facilitated monthly support groups for patients and patient families with HIV.
  • Lead support groups and activities related to overall patient advocacy, and interagency coordination.
  • Helped HIV/AIDS clients find support groups, health resources HIV/AIDS education Manage caseloads of 65-70 clients.
  • Organize and schedule events such as support groups and trainings for clients in English and Amharic.

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111 Support Groups Jobs

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35. Social Security
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low Demand
Here's how Social Security is used in Medical Case Manager jobs:
  • Provided case management services for Social Security disability determination for claimants applying for SSDI or SSI insurance benefits.
  • Assisted clients with applying for Social Security Disability and monitored progress.
  • Helped clients apply and navigate the Medicaid/Medicare and Social Security System
  • Assisted clients with application for entitlement programs such as SNAP, Medicaid, Social Security, Choices and QMB.
  • Assisted clients apply for entitlement programs such as Food Stamps, Medicaid, Social Security, Choices and QMB.
  • Assist clients with accessing public assistance and or social security benefits and assisting with housing applications.
  • Conducted meetings, group home inspections and SSI/SSA review with social security officers.
  • Assisted with completing medical forms for HRA, Social Security, and VESID.
  • Coordinate entitlement processes, and collaborate with Social Security, Dept.
  • Assisted client to complete Social Security Disability Medical form Enrolled clients into Medicaid HMO's and QMB program by telephone.
  • Worked with clients on Social Security, Medicaid and Medicare, spenddowns, and other needed paperwork and services.

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16 Social Security Jobs

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36. Hipaa
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low Demand
Here's how Hipaa is used in Medical Case Manager jobs:
  • Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Reviewed health history of insurance applicants on a case-by-case basis while acting in compliance with all HIPAA guidelines and standards.
  • Prepared for HIPAA and JCAHO reviews, ensuring required brochures and pamphlets were available to patients in all clinics.
  • Performed Tele-Medicine interviews, to establish medical history for health insurance applicants, in accordance with HIPAA Privacy Laws.
  • Acted in compliance with all HIPAA guidelines and standards of care in client interactions.
  • Maintained Health Insurance Portability and Accountability Act (HIPAA) guidelines during client interactions.
  • Adhere to the requirements of the HIPAA Privacy Policies and Procedures.
  • Maintain clinical documentation and records that uphold all HIPAA regulations.
  • Exceeded departmental goals for quality of documentation and HIPAA compliance.
  • Secure client information per HIPAA standards.

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178 Hipaa Jobs

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37. Health Education
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low Demand
Here's how Health Education is used in Medical Case Manager jobs:
  • Administered proposal preparation, development, submission, and follow-through of grant applications to implement health education programs.
  • Provide direct supervision of case management and health education/outreach staff.
  • Provided necessary health education training for patients.
  • Provided regular health promotions and health education services to clients, including one-on-one counseling, organized and led group education classes.
  • Conducted a comprehensive and interactive health education course related to HIV prevention, treatment and adherence to medication.
  • Provide treatment adherence counseling and health education to HIV-positive patients enrolled in the New Opportunities for Women Program.
  • Provided health education and outreach services to local churches, schools, and homeless shelters.
  • Increased client knowledge about HIV disease as it pertains to health education and prevention.
  • Utilize MDCH guidance and industry expertise in conducting risk reduction and health education services.
  • Provided sexual health education and prevention methods to clients.
  • Provide health education and information to HIV infected patients.
  • Conduct health education courses to promote healthy living.
  • Provide health education and support for members.
  • Offer health education and risk reduction education.
  • Maintain client records and progress note recordings Facilitate evidence-based behavioral interventions and health education groups
  • Coordinated patient health education workshops and clinic staff in-service trainings.
  • Translated many health education materials for Shawnee and patient's legal and medical documents from other Spanish speaking countries.
  • Provided supportive Pre and Post HIV/STD counseling and health education, manage life skills and follow up.

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47 Health Education Jobs

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38. Interqual
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low Demand
Here's how Interqual is used in Medical Case Manager jobs:
  • Provide optimal outcome for patients and their families while adhering to InterQual criteria.
  • Experienced with InterQual, Midas, and Microsoft software.
  • Utilized Interqual criteria for utilization review.
  • Utilized Interqual Criteria to establish admission status, severity of illness, intensity of service, and discharge planning.
  • Evidence-based criteria used included the Medical Disability Advisor, Interqual Criteria, and Official Disability Guidelines.
  • Prepare for RAC audits using the InterQual and Millerman Criteria.
  • Experience in Interqual Guidelines, knowledge in Milliman Guidelines.
  • Use of Interqual, HMS, MCCM, and Medhost.
  • Discharge Planning * Utilization of Milliman and Interqual guidelines

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50 Interqual Jobs

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39. Data Entry
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low Demand
Here's how Data Entry is used in Medical Case Manager jobs:
  • Maintain up-to-date confidential records for documentation of case activity to include electronic case management data entry.
  • Completed data entry in three different data bases and effectively navigated frequently changing regulatory environments.
  • Maintain data entry of client-level reporting of encounters and referrals, allowing for consistent and timely data collection.
  • Set production and accuracy standards for Data Entry improving efficiency and accuracy by 35%.
  • Complete monthly data entry; submit monthly data reports and clinical documentation.
  • Performed data entry and analysis for program goals and objectives.
  • Complete required documentation, billing, and data entry
  • Complete required data entry into ARIES client database.
  • Perform data entry in the CareWare Database System.
  • Key Accomplishments: Implemented improved data entry measures to increase Homeless Management Information System compliance from 0% to 100%.
  • Control the purchase, data entry and integrity of the Metropass distribution monthly.

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367 Data Entry Jobs

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40. Medical Needs
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low Demand
Here's how Medical Needs is used in Medical Case Manager jobs:
  • Prepared catastrophic reports outlining probable future medical needs and expenses for seriously-injured workers.
  • Developed treatment plans geared towards the client and worked with the client to achieve their medical needs.
  • Educate patients on various medical diseases while teaching skills to better improve self-management of medical needs.
  • Collaborate with Medical Team to ensure client's medical needs are being met.
  • Completed medical intakes and treatment goals pertaining to client's medical needs.
  • Briefed clinical staff on each client's medical needs at weekly meetings.
  • Help the patients and their families with their social and medical needs.
  • Coordinated medical needs as directed by the physician on the case.
  • Assisted clients with medical needs by scheduling doctor's appointments.
  • Help oversee medical needs of 60 developmentally disabled adults.
  • Manage and direct medical needs of the claimant.
  • Help provide and find transportation for medical needs.
  • Conducted medical needs assessments of injured clients.

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435 Medical Needs Jobs

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41. Medical Staff
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low Demand
Here's how Medical Staff is used in Medical Case Manager jobs:
  • Work closely with other physicians and medical staff to facilitate appropriate documentation entered into patient's medical charts.
  • Work closely with medical staff to facilitate appropriate documentation entered in patient's medical history.
  • Collaborated with medical staff and provided interpretation for Spanish speaking injured workers.
  • Provide consultation services to the medical staff on the eligibility of the early intervention services for infants and toddlers.
  • Provide clients with Case Management Referrals to assist them in their treatment plan with the Medical staff.
  • Coordinate HIV testing results with Primary Medical staff at all sites throughout the Total Health Care organization.
  • Worked with insurance companies, medical staff, attorneys, and injured worker to coordinate medical care.
  • Work directly with medical staff to monitor each participants blood counts and follow through with prescribed medication.
  • Served as a liaison between patients with long-term health issues and medical staff.
  • Assisted patients and medical staff to acquire resources; discharge planning including placement
  • Facilitate care conferences with patients, families, and medical staff.
  • Position Summary: Help patients communicating with their providers and medical staffs at the medical center.

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495 Medical Staff Jobs

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42. Primary Care Services
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low Demand
43. RN
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low Demand
Here's how RN is used in Medical Case Manager jobs:
  • Determined appropriateness of alternative benefit utilization.
  • Worked closely with insurance carriers and attorneys to obtain authorization for surgeries and medication.
  • Earned certification as Worker's Compensation Medical Case Manager.
  • Drafted monthly reports documenting client physical and employment status, regularly updating claims adjusters on client ability to return to work.
  • Attended physician appointments with patients to ensure that proper treatment was received to ensure the quickest return to normalcy.
  • Confirm return to work and coordinate special accommodations with manager and Occupational Health Nurse as needed.
  • Experience with coordinating the Intern and Volunteer program and planning and organizing events at the agency.
  • Provide supervision and guidance to interns and volunteers in the provision of services to clients.
  • Maintain communication between all parties including the injured worker, physician, employer and attorneys.
  • Communicate effectively with all claims examiner, client, claimant, supervisor and attorney.
  • Coordinate any request for extension if employee is not returning to work.
  • Coordinated and negotiated a prompt return to work with employer.
  • Meet with employers to coordinate returns to work.
  • Offer crisis counseling for individual's concerns.
  • Evaluated need for alternate treatment.
  • Performed initial and ongoing clinical assessment and evaluate For alternate treatment.
  • Assisted the client in reaching the optimal level of function and/or returning to work in a timely manner.
  • Attended claimant appointments and coordinated medical care for best outcome and return to work
  • Attend government stakeholder meetings and take meeting notes which are later shared internally.
  • Full time RN Case Manager for medical patients.

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10,698 RN Jobs

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44. Hippa
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low Demand
Here's how Hippa is used in Medical Case Manager jobs:
  • Maintained HIPPA compliant clinical documentation of patient information in 3M electronic health information system.
  • Maintained confidentiality per HIPPA regulations.
  • Complied with all HIPPA regulations as related to case management, file maintenance and privacy of health information.
  • Maintained client and family confidentiality per HIPPA regulations; complied with all CAP policies and procedures.
  • Communicate with patients and family members in a confidential and professional manner while maintaining HIPPA standards.
  • Complete documentation in accordance to HIPPA standards, and complete ongoing training and continued education.
  • Be knowledge of Health Insurance Portability Accountability Act (HIPPA).
  • Assessed, collected, and maintained accurate client information and records in a confidential manner in compliance with HIPPA.
  • provided a confidential phone enviornment coherent with Hippa Laws.
  • Receive, review and route medical records in accordance with HIPPA.

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45. EMR
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low Demand
Here's how EMR is used in Medical Case Manager jobs:
  • Verified and documented patient's medical history in EMR system while adhering to strict compliance with patient confidentiality and HIPAA laws.
  • Interview and assess patients, document findings and input into Electronic Medical Record (EMR) System.
  • Utilized Spring Charts (EMR) to efficiently maintain accurate records and document all case management activities.
  • Update clinic patient profiles in EMR and serve as a liaison between patients and providers.
  • Participated in the implementation and building of a Practice Management and an EMR software.
  • Assure that Medicare IM letters were signed and documented in EMR system.
  • Secured medical records via phone and EMR.
  • Reviewed/discussed new regimens and treatments Maintained medical information via EMR systems
  • Case manage clients at clinic in Uptown using Centricity EMR to complete notes, schedule clients, and extract medical information.
  • Facilitated return or work per state guidelines * Maintained a medical file on each patient and updated EMR
  • Complete documentation within EMR (Electronic Medical Records) in a timely fashion.
  • Document and bill for services timely and appropriately in CAREWare and EMR.
  • Maintain accurate client files and records in PROVIDE System/Cerner EMR.
  • Lead Clinical Council for department change Development of Physician Discharge Guidelines for EMR Identify CHP CORE Measures and ensure care compliance.

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24 EMR Jobs

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46. Insurance Adjusters
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low Demand
Here's how Insurance Adjusters is used in Medical Case Manager jobs:
  • Consulted with insurance adjusters for medical file reviews of cases to determine appropriate medical interventions.
  • Developed monthly reports for insurance adjusters.
  • Prepare monthly progress reports on assigned cases for insurance adjusters and State regulatory agencies.
  • Acted as timely liaison among insurance adjusters, claimants, providers, employers.
  • Provide educational presentations to insurance adjusters and employers on topics related to management of workinjuries.

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6 Insurance Adjusters Jobs

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47. Monthly Reports
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low Demand
Here's how Monthly Reports is used in Medical Case Manager jobs:
  • Generate monthly reports on overall performances according to DCFS regulations.
  • Post payments, close cases, manage monthly reports, verify receivable and payable postings.
  • Prepared monthly reports for clients and for the Department of Health.
  • Write monthly reports with updates for clients or as contract specifies.
  • Maintained individual patient charts, enrollment databases and monthly reports.
  • Submitted monthly reports to all legally responsible parties.
  • Created weekly and monthly reports and presentations.
  • Prepare monthly reports for Quality Management meetings * Prepare quarterly reports for Utilization review.
  • Prepared monthly reports to insure continuation of client care and payment of benefits as required by law.
  • Completed outcome monthly reports to monitor and assure effectiveness and compliance of each contract.
  • Provided all billable hours with monthly reports including cost-effectiveness to the adjustor.
  • Provide transportation, and complete monthly reports Maintain complete confidentially of all clients
  • Prepared weekly and monthly reports/notes for Ryan White CAREWare.
  • collect and submit required data for monthly reports Provided back up Pre/Post Test Counseling for HIV testing.

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25 Monthly Reports Jobs

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48. Providers
demand arrow
low Demand
Here's how Providers is used in Medical Case Manager jobs:
  • Collaborated with providers, members and families implementing plans of treatment to optimize utilization of resources and benefits.
  • Attend interdisciplinary team meetings and coordination of services among multiple providers, including mental health providers.
  • Provided crisis management and intervention when appropriate and assisted client and service providers in problem solving.
  • Negotiated level of care, intensity and disability duration with providers.
  • Coordinated patient care with other providers/referrals including medical, legal, housing, behavioral health, and employment.
  • Worked with medical providers and injured workers in order to determine the most beneficial treatment plan.
  • Advise children and their families on covered and non-covered services, eligible providers and authorizations.
  • Participated in weekly meetings with other service providers to collaborate on clients Case Management needs.
  • Coordinated therapies, home care providers, transportation, DME, and other needs.
  • Provided patient's severity of illness and intensity of service to insurance providers.
  • Coordinate appropriate medical treatment, the length of disability with providers.
  • Consulted with care providers to assemble care plans while ensuring confidentiality.
  • Worked closely with medical, AHCCCS or other insurance providers.
  • Served as a Liaison between the Soldier and Medical Providers.
  • Respond to medical providers as needed.
  • Monitor formulary updates or changes and notify providers and patients to ensure continuity of patient care and contractual financial responsibility.
  • Identify medical and/or mental health issues while working directly with providers Initiate cases to manage medical readiness
  • Established and monitored rehabilitation plans in cooperation with employer, employee and healthcare providers.
  • Collaborate with providers/medical specialists, home health and other ancillary healthcare providers with the goal being to coordinate member care.
  • Collaborate with Medical Director regarding denial and Letters of Agreements with noncontractor providers.

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3,487 Providers Jobs

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49. Timely Return
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low Demand
Here's how Timely Return is used in Medical Case Manager jobs:
  • Facilitated a timely return to work date by establishing a professional working relationship with the claimant, physician, and employer.
  • Developed Individual Medical Case Management Plans for injured team members to ensure their timely return to work.
  • Coordinate care for the injured worker to facilitate a timely return to work.
  • Maximized timely return to work full duty according to Milliman & Robertson criteria.

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50. Medical Knowledge
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low Demand
Here's how Medical Knowledge is used in Medical Case Manager jobs:
  • Implemented medical knowledge and familiarity with insurance products and policies to assess and coordinate treatment of catastrophic Worker's Compensation injuries.
  • Utilized medical knowledge and skills to accurately convey each patients medical history to aid in the underwriting process.

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72 Medical Knowledge Jobs

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Medical Case Manager Jobs

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20 Most Common Skills For A Medical Case Manager

HIV

9.3%

Treatment Plans

8.7%

Patient Care

8.2%

Health Care

8.1%

Appropriate Medical Care

8.1%

Financial Assistance

7.7%

Mental Health Services

6.6%

Management Services

5.4%

Service Plans

4.7%

Community Resources

4.6%

Insurance Companies

4.0%

Medical Records

4.0%

Medical Treatment

3.4%

Substance Abuse

3.1%

Medical Care Providers

2.5%

Support Services

2.4%

Utilization Review

2.4%

Medical Conditions

2.4%

Intake Assessments

2.2%

Appropriate Referrals

2.1%
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Typical Skill-Sets Required For A Medical Case Manager

Rank Skill
1 HIV 6.9%
2 Treatment Plans 6.5%
3 Patient Care 6.1%
4 Health Care 6.0%
5 Appropriate Medical Care 6.0%
6 Financial Assistance 5.7%
7 Mental Health Services 4.9%
8 Management Services 4.0%
9 Service Plans 3.5%
10 Community Resources 3.4%
11 Insurance Companies 2.9%
12 Medical Records 2.9%
13 Medical Treatment 2.5%
14 Substance Abuse 2.3%
15 Medical Care Providers 1.9%
16 Support Services 1.8%
17 Utilization Review 1.8%
18 Medical Conditions 1.8%
19 Intake Assessments 1.6%
20 Appropriate Referrals 1.6%
21 Medical Appointments 1.5%
22 Medical Management 1.5%
23 Treatment Adherence 1.4%
24 Social Workers 1.4%
25 Medical Services 1.3%
26 Link Clients 1.3%
27 Crisis Intervention 1.1%
28 Medical Necessity 1.1%
29 Durable Medical Equipment 1.1%
30 Customer Service 1.0%
31 Risk Reduction 1.0%
32 Medication Adherence 0.9%
33 Care Coordinator 0.9%
34 Support Groups 0.8%
35 Social Security 0.8%
36 Hipaa 0.8%
37 Health Education 0.8%
38 Interqual 0.7%
39 Data Entry 0.7%
40 Medical Needs 0.6%
41 Medical Staff 0.6%
42 Primary Care Services 0.6%
43 RN 0.6%
44 Hippa 0.6%
45 EMR 0.5%
46 Insurance Adjusters 0.5%
47 Monthly Reports 0.5%
48 Providers 0.5%
49 Timely Return 0.5%
50 Medical Knowledge 0.4%
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17,270 Medical Case Manager Jobs

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