Job Description

Job Title: Remote Case Manager

Location: North Miami area (Remote with local travel)

Time Zone: Eastern Standard Time

Position Type: Full-time, Remote

Summary: The Remote Case Manager is responsible for health care management and coordination of Managed Care members in the North Miamiarea to achieve optimal clinical, financial, and quality of life outcomes. Working remotely, this position involves regular local travel to assisted living facilities, nursing homes, and members' homes for face-to-face visits. The Case Manager will collaborate with members to create and implement integrated care plans, monitor progress, and ensure consistent, cost-effective care in compliance with policy and regulations.

Must-Have Requirements:

• Bachelor's degree in related fields such as social work or health administration, LPN or RN or degree in social work/psychology

Desired Work Hours: 8:30 AM – 5:00 PM

Responsibilities:

• Conduct face-to-face visits with members in assisted living facilities, nursing homes, and sometimes homes to assess their healthcare needs.
• Set up appointments every 90 days or as needed to review and update care plans.
• Arrange transportation for members if needed.
• Identify gaps in care and healthcare needs, and access resources to address them.
• Assist caregivers with day-to-day stress and provide support.
• Coordinate transitions between healthcare settings, including hospital discharge planning.
• Assess eligibility for long-term care services and support.
• Connect members with community resources and social services programs.
• Arrange additional services as needed, such as physical therapy or meal delivery, in collaboration with primary care providers, family members, and other providers.

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