Medical Case Manager

TL;DR

Medical Case Manager (Healthcare): Facilitating holistic care coordination for members with complex medical and psychosocial needs with an accent on clinical assessment, care planning, and interdisciplinary collaboration. Focus on improving health outcomes through in-home visits, provider coordination, and effective resource management within the Delaware territory.

Location: Must be based in Delaware; this is a hybrid role requiring frequent travel within the assigned community.

Company

hirify.global is a national health and wellness organization providing comprehensive healthcare services and insurance solutions.

What you will do

• Conduct holistic assessments and develop individualized care plans for members with complex needs.
• Coordinate care by collaborating with primary care physicians, specialists, and community agencies.
• Perform in-home and community-based visits to monitor member progress and care plan adherence.
• Advocate for appropriate care plans using sound clinical judgment and cost-benefit analysis.
• Participate in interdisciplinary team meetings to facilitate service coordination and resource identification.
• Maintain accurate documentation of member interventions in compliance with regulatory guidelines.

Requirements

• Must be based in Delaware or able to work within the assigned territory.
• Bachelor’s degree in Nursing (with RN certification) OR Master’s degree in Social Work, Counseling, or related field.
• Minimum 3 years of experience in Acute Care, Managed Care, Medicaid, or Medicare populations.
• Current state licensure as an RN, LSW, LPC, LBSW, LCSW, LMSW, or LGSW.
• Ability to perform frequent travel within the assigned community.
• Strong communication skills for telephonic interviewing and interdepartmental collaboration.

Nice to have

• Bilingual English/Spanish language skills.
• Case Management Certification.
• Experience working with high-risk pregnant women, chronic adult conditions, or pediatrics.

Culture & Benefits

• Full-time employment with comprehensive health and wellness benefits.
• Opportunity to work in a hybrid environment balancing remote work and community engagement.
• Professional development through continuing education forums and internal training.
• Collaborative team environment focused on improving patient health outcomes.