Care Management Clinician - RN/LCSW | CCM Certified

• Clinician Care Managers facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation
• Collect and assess patient information pertinent to patient’s history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services
• Based on the needs and values of the client, and in collaboration with all service providers, the clinician links clients with appropriate providers and resources throughout the continuum of health and human services and care settings
• Ensure that the care provided is safe, effective, client-centered, timely, efficient, and equitable
• Clinicians have direct communication among the client, the payer, the primary care provider, and other service delivery professionals
• Interact with other PacificSource personnel to assure quality customer service is provided
• Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies
• Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients
• Practice and model effective communication skills: both written and verbal
• Utilize and promote use of evidence-based tools
• Utilize lean methodologies for continuous improvement

Requirements Minimum of three (3) years of clinical experience, including case management Insurance industry experience preferred Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) also required at time of hire or within two years of hire date Knowledge of health insurance and state mandated benefits Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation Ability to deal effectively with people who have various health issues and concerns Knowledge and understanding of contractual benefits and options available outside contractual benefits Knowledge of community services, providers, vendors and facilities available to assist members Ability to use computerized systems for data recording and retrieval ATS Optimization Keywords Below are skills and terms extracted directly from this job posting to improve Applicant Tracking System (ATS) visibility. This unique feature helps candidates tailor their applications more effectively — a feature exclusive to JobTailor job listings. Hard Skills Advocacy Assessment Planning Resource Management Service Facilitation Data Recording Data Retrieval Evidence-Based Tools Lean Methodologies Soft Skills Effective Communication Interpersonal Skills Certifications & Qualifications Registered Nurse (RN) License Licensed Professional Counselor (LPC) Licensed Marriage and Family Therapist (LMFT) Licensed Clinical Social Worker (LCSW) Certified Case Manager Certification (CCM) #J-18808-Ljbffr Jobtailor