Care Management Clinician (Monday-Friday)

We are an equal‑opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information, or age. Role Overview Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet clients’ health and human service needs. Clinicians incorporate key case‑management functions to enhance patients’ quality of life and maximize health plan benefits, including coordination and delivery of care, consideration of physical, psychological, and cultural factors, assessment of patient benefits, and identification of additional medical, community, or financial resources. Essential Responsibilities Facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. Collect and assess patient information to develop a comprehensive, individualized care management plan that promotes appropriate utilization and cost‑effective care. Link clients with appropriate providers and resources throughout the continuum of health and human services, ensuring care is safe, effective, client‑centered, timely, efficient, and equitable. Maintain client privacy, confidentiality, and safety through advocacy and adherence to ethical, legal, accreditation, certification, and regulatory standards. Interact with PacificSource personnel to assure quality customer service and act as an internal resource for medical or contract interpretation questions. Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. Practice effective written and verbal communication skills, utilize evidence‑based tools, and apply lean methodologies for continuous improvement. Supporting Responsibilities Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. Success Profile 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) required at hire or within two years. Knowledge of health insurance, state‑mandated benefits, contractual benefits, community services, and computerized systems for data recording and retrieval. Ability to work independently with minimal supervision and maintain current clinical knowledge. Competencies Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Environment & Travel Work inside a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills Accountability Collaboration Communication (written & verbal) Flexibility Active Listening Organizational skills / Planning and Organization Problem Solving Teamwork Compensation Base Range: $70,950.00 – $106,424.99 (actual compensation will be determined based on experience, education, and internal equity). Benefits Flexible telecommute policy Medical, vision, and dental insurance Incentive program Paid time off and holidays 401(k) plan Volunteer opportunities Tuition reimbursement and training Life insurance Flexible spending account options Physical Requirements Stoop and bend; sit and/or stand for extended periods. Repetitive motions including typing, sorting, and filing. Light lifting and carrying of files and business materials. Read and comprehend written and spoken English. Communicate clearly and effectively. Legal Notice Employment remains at‑will. This job description is not a contract and is subject to change. PacificSource is a company that values diversity and inclusion and is an equal opportunity employer. For more information, review our policy statement. #J-18808-Ljbffr PacificSource