Community Health Case Manager

Job Description

Job Description

Position Summary

The Community Health Case Manager coordinates comprehensive, patient-centered care for PHC's uninsured, predominantly Spanish-speaking patients across Summit and Wasatch Counties. Working fluently in both English and Spanish, the Case Manager carries a caseload of patients with complex medical and social needs, developing and managing individualized care plans, connecting patients to medical and community resources, and following patients over time to ensure continuity of care.

Key Responsibilities

Case Management and Care Coordination

• Carry and manage a caseload of patients with complex medical and social needs, conducting assessments and collaborating with the clinical care team to develop and maintain individualized, patient-centered care plans
• Coordinate care across the continuum, including scheduling and reminders for primary, specialty, and subspecialty appointments, arranging transportation, and ensuring the timely completion of applications
• Assist patients with access to care and coverage, including medication access assistance and Medicaid enrollment applications when applicable
• Connect patients to community resources and conduct home visits when needed to provide patient education and support

Documentation and Program Support

• Document individual contacts, visits, and outcomes data in the Electronic Health Record accurately and in a timely manner
• Advocate for and support technology-enabled patient education and care
• Contribute to the achievement of established program goals and objectives, and adhere to department policies, procedures, and quality standards

Collaboration and Community Partnership

• Collaborate with providers, case management and community health team members, and community partners to coordinate quality patient care
• Build and maintain relationships with community partners to establish and sustain ongoing support options
• Serve as a resource and mentor to community health workers and case management staff on complex cases

Experience

Prior experience in a clinical or case management setting is required. Relevant background may include work as a case manager, social worker, community health worker, medical assistant, patient navigator, or receptionist. At least two years of experience in a clinical or case management setting is required, with direct case management experience preferred.

Qualifications and Education

• Must be fluent in English and Spanish
• Bachelor's degree or higher preferred, ideally in social work, public health, nursing, or a related field
• Excellent verbal and written communication skills
• Proficiency with electronic health records and Microsoft Office
• Highly organized with strong attention to detail and the ability to manage a caseload
• Strong problem-solving and critical-thinking skills
• Able to work effectively with a diverse patient population, with exceptional customer service and interpersonal skills

Who Thrives Here

We are looking for someone who brings warmth, cultural humility, and persistence to their work, who is energized by helping patients navigate a complex system, and who thrives in a collaborative, resource-conscious environment devoted to caring for our uninsured community.