REMOTE Case Manager - 346345

Location: Remote (Must reside in the Tri-State Area; preference for New York City or NY State) Schedule: Monday – Friday, 9:00 AM – 5:30 PM EST (Full-Time, 40 hours/week) Position Type: Full-Time Job Summary We are seeking a patient-centered, empathetic, and highly organized Remote Care Manager to join our team. In this role, you will engage health plan members telephonically to assess health-related social needs, coordinate vital community referrals, navigate care services, track member outcomes, and ensure the successful completion of care plans. The ideal candidate has proven experience supporting Medicaid populations, a deep understanding of the Social Determinants of Health (SDOH), and the technical aptitude to navigate multiple systems seamlessly in a remote work environment. Key Responsibilities Member Screening & Needs Assessment Conduct outbound telephonic outreach to members to assess social determinants of health, including housing instability, food insecurity, transportation barriers, and healthcare access. Complete comprehensive social needs assessments, prioritize members based on acuity/risk factors, and identify care gaps or unmet community resource needs. Build trust and rapport with members and caregivers to understand their unique circumstances, goals, and barriers to health. Care Coordination & Follow-Up Develop and execute individualized care plans based on member assessments and personal goals. Coordinate targeted referrals to community-based organizations, healthcare providers, and social service agencies. Conduct proactive follow-ups via phone, text, or digital platforms to ensure member connection to recommended services. Identify and overcome barriers to care, including financial constraints, transportation, language, or system navigation challenges. Referral Management Manage, track, and monitor referrals through established workflows to ensure service delivery and completion. Follow up with community partners, providers, and service organizations to verify member engagement and outcomes. Escalate unresolved referrals or service delays per established organizational protocols. Member Engagement & Education Educate members and caregivers on navigating healthcare systems, social service programs, and available community supports. Utilize motivational interviewing and culturally competent communication to encourage self-advocacy and care plan adherence. Documentation & Data Management Maintain accurate, timely documentation of all member interactions, assessments, referrals, and outcomes within the Electronic Health Record (EHR) / care management platform. Ensure strict compliance with HIPAA, organizational policies, and regulatory mandates. Track key performance indicators (KPIs), including referral completion rates, care gap closures, and engagement metrics. Collaboration & Quality Improvement Collaborate with interdisciplinary teams (nurses, social workers, care managers, providers, and community partners). Participate in regular case reviews, team meetings, and quality improvement initiatives to optimize workflows and care coordination effectiveness. Required Qualifications & Skills Location: Must currently reside in the Tri-State Area (Strong preference for New York State or NYC residents). Medicaid Experience: Demonstrated experience working with Medicaid populations and addressing Social Determinants of Health (SDOH). Care Management: Proven background in care management, care coordination, or social services. Tech-Savvy: High comfort level navigating multiple software platforms, databases, and electronic health records (EHR). Ability to multitask across applications efficiently. Dedicated Remote Workspace: Must have a quiet, dedicated, closed-door home office free from background noise and distractions. Hardware & Connectivity Requirements: High-speed internet connection with a direct Ethernet connection (hardwired setup required). Preferred Qualifications Language: Bilingual in Spanish (strongly preferred). Specialized Experience: Health Home Care Management experience (strongly preferred). Software: Experience with Microsoft Teams and collaboration software. Home Office Setup: Dual/multiple monitors and a dedicated USB/wireless headset (strongly preferred). What We Offer Work From Home: 100% remote position within the Tri-State area. Consistent Hours: Standard daytime business hours with no weekend or late-night shifts required. Impactful Work: Opportunity to make a direct, meaningful difference in the lives of vulnerable populations and local communities. #J-18808-Ljbffr Medix™