Clinical Case Manager

Capital Health Plan•Tallahassee, FL

1d•Onsite

About The Position

Capital Health Plan is seeking a dedicated Clinical Case Manager to join their team in Tallahassee, FL. This full-time role involves leveraging clinical expertise, leadership skills, and a commitment to quality care to support members with complex healthcare needs. The organization is recognized for excellence, compassion, and innovation.

Requirements

Bachelor's degree or equivalent combination of education and related experience
Licensed Medical Professional
Current Certified Case Manager (CCM) certification or able to obtain within 12 months of hire
Strong communication, problem-solving, and care coordination skills
Ability to manage complex, chronic, and/or catastrophic medical cases
Knowledge of medical coding, regulatory guidelines, and evidence-based clinical practices
Proficiency with Microsoft Office applications
Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents
Ability to effectively present information to top management, public groups, and/or boards of directors
Strong math skills

Responsibilities

Serve as the driving force behind coordinated, high-quality care for a designated panel of members.
Assess healthcare needs.
Develop personalized care plans.
Collaborate with physicians and multidisciplinary care teams.
Connect members with valuable resources to help them achieve their health goals.
Identify opportunities to improve outcomes.
Remove barriers to care.
Monitor progress.
Use clinical expertise to ensure every intervention supports both quality and efficiency.