Case Manager

Premier Community Healthcare Grp.•Dade City, FL

5d•Remote

About The Position

The Case Manager supports patients with complex, high-risk, or chronic health conditions through coordinated, patient-centered care. This role serves as a liaison between patients, providers, insurance partners, and community resources to ensure continuity of care, reduce barriers, and improve health outcomes. The Case Manager plays a critical role in care coordination, quality initiatives, and patient advocacy.

Requirements

Basic understanding of medical terminology and healthcare documentation
Strong organizational, analytical, and problem-solving skills
Excellent communication skills, both verbal and written
Ability to work effectively with diverse populations and interdisciplinary teams
Demonstrates empathy, professionalism, and ethical conduct
Strong customer service orientation with a patient-first mindset
Licensed Practical Nurse (LPN) or Associate degree in nursing, social work, or a related field (required)
Minimum of five (5) years of nursing or healthcare experience
Ability to obtain and maintain EHR (e.g., Epic) certification and required compliance training

Nice To Haves

At least one (1) year of case management or related experience preferred
Experience with HEDIS, quality metrics, or care coordination preferred
Current Basic Life Support (BLS) certification preferred

Responsibilities

Manage a caseload of high-risk and high-cost patients with complex medical and social needs
Identify gaps in care, barriers to treatment adherence, and social determinants impacting health
Conduct outreach and pre-visit planning to support care coordination and follow-up
Collaborate with providers, care team members, and insurance partners to ensure continuity of care
Upload required documentation into insurance portals to meet quality and compliance standards
Create and analyze reports to monitor high-risk populations and care outcomes
Coordinate referrals, authorizations, and access to community resources and support services
Assist with clerical tasks including obtaining medical records, lab results, and consultation notes
Participate in quality improvement initiatives and required meetings
Maintain accurate documentation in the Electronic Health Record (EHR)
Ensure confidentiality and HIPAA compliance at all times
Represent the organization’s mission, values, and commitment to patient-centered care
Perform other duties as assigned