REMOTE Case Manager - 313567

Remote Care ManagerLocation: Fully RemoteSchedule: Monday–Friday, 9:00 AM – 5:30 PM ESTHours: Full-Time, 40 Hours Per WeekMake a Difference in Your CommunityWe are seeking a compassionate and driven Care Manager to support Medicaid members by connecting them to essential healthcare and community resources. In this role, you will engage members telephonically, assess social determinants of health, coordinate referrals, and help remove barriers that impact health outcomes and quality of life.This is an excellent opportunity for someone who is passionate about serving underserved populations, enjoys building meaningful member relationships, and thrives in a remote, mission-driven environment.Key ResponsibilitiesMember Assessment & OutreachConduct outbound phone outreach to members to assess social determinants of health, including:Housing instabilityFood insecurityTransportation barriersAccess to healthcare servicesComplete comprehensive social needs assessments and identify gaps in care.Build trusting relationships with members and caregivers to understand their goals, challenges, and support needs.Prioritize members based on acuity, risk level, and identified social needs.Care Coordination & Case ManagementDevelop individualized care plans based on assessment findings.Coordinate referrals to community-based organizations, healthcare providers, and social service agencies.Conduct ongoing follow-up outreach to ensure members successfully connect with recommended services.Identify and address barriers to care, including financial, transportation, language, and access-related challenges.Support members in navigating healthcare systems and community resources.Referral ManagementTrack and manage referrals from initiation through completion.Monitor referral outcomes and ensure services are received and documented appropriately.Collaborate with providers, community partners, and service organizations to verify member engagement and outcomes.Escalate unresolved referrals or service delays according to established guidelines.Member Education & AdvocacyEducate members and caregivers on available healthcare and community resources.Utilize motivational interviewing and culturally competent communication techniques to promote engagement.Encourage self-advocacy and adherence to care plans and recommended services.Documentation & ComplianceAccurately document all member interactions, assessments, referrals, and outcomes within care management systems.Maintain compliance with HIPAA and organizational policies.Track referral completion rates, member engagement metrics, and care gap closure activities.Ensure timely and accurate documentation and reporting.Collaboration & Quality ImprovementPartner with interdisciplinary teams including nurses, social workers, care managers, providers, and community organizations.Participate in case reviews, team meetings, and quality improvement initiatives.Identify opportunities to improve member engagement, referral workflows, and care coordination processes.Required QualificationsExperience working with Medicaid populations.Previous Care Management, Case Management, Care Coordination, or Community Health experience.Strong technology and computer skills with the ability to navigate multiple systems simultaneously.Excellent organizational and multitasking abilities.Strong communication and member engagement skills.Ability to work independently in a remote environment.Home Office RequirementsDedicated, quiet, distraction-free workspace with a door.Reliable high-speed internet connection.Ethernet connection required.Ability to maintain confidentiality while working remotely.Preferred QualificationsHealth Home Care Management experience strongly preferred.Bilingual in any language preferred.Experience addressing Social Determinants of Health (SDOH).Multiple monitor setup preferred.Professional headset strongly preferred.Why Join Us?100% Remote PositionMonday–Friday schedule with no weekendsOpportunity to positively impact underserved Medicaid populationsHelp connect members to critical day-to-day necessities and community resourcesCollaborative and supportive team environmentJoin a growing organization committed to improving health outcomes and reducing barriers to careMeaningful work that directly impacts the communities we serveSchedule: Monday–Friday, 9:00 AM – 5:30 PM ESTEmployment Type: Full-Time (40 Hours Weekly)