Junior Case Management Coordinator

We are seeking a medically knowledgeable and customer-focused Junior Case Management Coordinator to support our care management team. In this outreach-based role, you will proactively engage insured members with chronic conditions, recent hospitalizations, or care gaps to help facilitate timely, appropriate healthcare services. This position is ideal for candidates with a clinical background.

Key Responsibilities

• Reach out to existing insured members by phone to:
• Conduct basic health assessments
• Review care needs and follow-up status
• Provide information on available care programs and resources
• Support case managers and RNs in implementing care plans by collecting member information and scheduling services.
• Document all member interactions and clinical findings accurately in the case management system.
• Collaborate with providers, facilities, and care teams to coordinate services such as DME, home health, or specialist referrals.
• Review member utilization and claims history to flag high-risk cases for clinical staff.
• Ensure all outreach activities follow HIPAA and health plan guidelines.
• Educate members on covered benefits, preventive care, and care navigation.

Job Requirements

• LPN Degree
• Medical background required
• 5 years of experience in a healthcare, insurance, or medical office setting.
• Knowledge of clinical workflows, common medical terminology, and basic chronic disease management
• Familiarity with managed care processes (e.g., authorizations, referrals).
• Strong interpersonal and communication skills with a patient-centered approach.
• Comfortable conducting outreach calls in a high-volume, structured environment.
• Proficiency in Microsoft Office products