About The Position

As a Case Manager Analyst, you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services. Using care management tools and data analysis, you assess member needs, identify risks, and develop and implement effective care plans. You collaborate with internal teams, providers, and external resources to address barriers, improve quality of care, and ensure services align with member benefits. Through communication, coaching, and motivational techniques, you promote member engagement, informed decision-making, and healthy behavior changes. You are responsible for monitoring care plan progress, documenting activities, and ensuring compliance with regulatory standards, company policies, and quality management guidelines.

Requirements

  • Bilingual (English & Spanish): Required. Must successfully pass both verbal and written language assessments.
  • Must have reliable transportation and be willing/able to travel up to 75% of the time.
  • Must reside in Miami-Dade County, FL within zip codes 33185, 33193, or 33196.
  • At least 1 year in a behavioral health or long-term care setting.
  • Proficiency in Microsoft Office Suite as well as computer use.

Nice To Haves

  • Experience in discharge planning, case management, or managed care (MCO).
  • Strong ability to multitask, prioritize, and adapt in a fast-paced environment.
  • Advanced communication skills in both English and Spanish (verbal and written).

Responsibilities

  • Coordinating care
  • Providing education
  • Facilitating access to appropriate healthcare services
  • Assessing member needs
  • Identifying risks
  • Developing and implementing effective care plans
  • Collaborating with internal teams, providers, and external resources to address barriers, improve quality of care, and ensure services align with member benefits
  • Promoting member engagement, informed decision-making, and healthy behavior changes through communication, coaching, and motivational techniques
  • Monitoring care plan progress
  • Documenting activities
  • Ensuring compliance with regulatory standards, company policies, and quality management guidelines

Benefits

  • New Hire Bonus Available!
  • Mileage is reimbursed per company policy.
  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility
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