Medical Fund Clinical Case Manager

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.-all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in three Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com . PCG is currently seeking a qualified Case Manager. The Case Manager will be responsible for assisting enrollees of a publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers navigate healthcare benefits offered through this Fund. The Case Manager will also be responsible for utilizing a case management software system on a day-to-day basis. The purpose of the Fund is to provide a funding source for future health care costs associated with birth-related neurological injuries. The Case Manager will also assist in development of program policies and procedures, and program improvement processes. The Fund operations include, performing assessments, providing case management services, assisting families and program recipients through prior approval of certain healthcare services, and collaborating with the claim's administration team. Successful candidates will be accountable for the full patient care cycle. Duties and Responsibilities Responsible for helping program recipients, family members, and caretakers navigate healthcare benefits Assists in the development of program policies and procedures Responsible for the full patient care cycle. Assesses, plans, implements, monitors and evaluates actions required to meet the client's health and human services needed. Coordinates and provides care that is safe, timely, effective, efficient, equitable, and client-centered Handles case assignments, draft service plans, review case progress and determine case closure Travels within the State to conduct periodic in person assessments Facilitates multiple care aspects (case coordination, information sharing, etc.) Helps patients make informed decisions by acting as their advocate regarding their clinical status and treatment options Develops effective working relations and cooperate with medical team throughout the entire case management process Interacts with patients to keep track of their progress and to ensure satisfaction Records case information, complete accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes Assesses and addresses motivational and psychosocial issues Adheres to professional standards as outlined by protocols, rules and regulations Required Skills Excellent communication, interpersonal and client-facing skills. Ability to work independently and on a team. Proven working experience in case management, including as a nurse, medical, mental health care manager or a related job Excellent knowledge of case management principles, healthcare management and reimbursement Previous experience with psychological aspects of care Effective communication skills Excellent organizational and time management skills Familiarity with professional and technical emerging knowledge Problem solving skills and ability to multi-task Compassionate with teamwork skills Qualifications BS degree in related healthcare field preferred Experience working with pediatrics; Experience or educational training in health or social services, preferably including work experience or a practicum that involved the performance of assessments and the development of case management plans. Current license, certification or registration as a Registered Nurse or Social Worker Working Conditions Remote with some infrequent on site visits. The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities or skills of personnel so classified. #LI-MB1 #LI-Remote Compensation: Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides a reasonable range of compensation for this role. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave. Range: $78,500 - $100,000 PCG does not sponsor newly hired foreign national workers for work authorization, including H-1B sponsorship. EEO Statement: Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work. Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.