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Case Manager - Medical
Career Insights for Clinical Case Manager
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Based on Florida data
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What they do
A Clinical Case Manager coordinates medical care and provides advocacy to help people get the best and most affordable care. Helps patients navigate insurance and hospital bureaucracies and access information. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment and travel to different doctors' offices, hospitals or a patient's home.
$56,234 / year median in Florida
+9% projected growth
Job Description
Medical Essential Job Functions:
Completes assessments and service plans that assist clients in developing goals and addressing areas of need, and reviews the assessments and service plans according to program guidelines. Completes authorizations and reauthorizations as required by program guidelines. Participates in client treatment planning and case review with other client care providers. Documents service activity in SMA's EMR, and ensures the medical record is up to date, accurate, and meets all documentation standards in accordance with program requirements. Coordinates and provides care that is safe, timely, effective, efficient, equitable, and client-centered. Executes linkages identified on the service plan and monitor progress of service delivery according to program guidelines. Facilitates client access to community resources, including locating recreational activities, housing, food, clothing, school programs, vocational opportunities or services, providers to teach life skills, and relevant mental health and substance use services. Assists clients with identifying financial assistance options for medications and other medical needs. Assists clients with developing natural resources and making contact with social support networks. Helps clients make informed decisions by acting as their advocate regarding their clinical status and treatment options. Communicates clients' progress by conducting/attending interdisciplinary meetings and evaluations; disseminating results and obstacles to therapeutic team and family; and identifying treatment influences. Provides limited crisis intervention under appropriate supervision. Reports any concerns regarding the health, safety, or well-being of a client to the appropriate authority. Facilitates access to and/or coordinates transportation for clients in order to execute linkages identified on the service plan. Attends court hearings as required by program guidelines. Maintains an awareness of proper safety procedures and guidelines and applies these in performing daily activities and tasks. Provides administrative support and performs general office duties such as answering the phone, communicating with internal and external customers, and cleaning as required by program. Adheres to professional standards as outlined by protocols, rules and regulations. Additional duties may be required as per specific program guidelines.Qualification Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum Education and/orExperience:
High School Diploma required.Bachelor's Degree from an accredited university or college with a major in counseling, social work, psychology, criminal justice, nursing, rehabilitation, special education, health education, or other related human services field preferred; a minimum of one year of full time or equivalent experience working with the target population preferred. A Bachelor's Degree from an accredited university or college in a discipline other than previously noted will be considered if the candidate has three years of full time or equivalent experience working with the target population. Preference will be given to those who are certified as Targeted Case Managers. Additional education and/or experience may be required as per specific program guidelines. Certification as a Targeted Case Manager may be required within six months of hire depending on program guidelines.