Clinical Case Manager

Activate Care

Clinical Case Manager providing clinical oversight and case consultation in a hybrid role with Medicaid populations. Enhancing health equity through community care at Activate Care.

Posted 7/10/2026full-timeLas Vegas • Nevada • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Serve as the embedded clinical resource for a team of CHWs
Provide real-time case consultation, clinical guidance, and side-by-side assistance to CHWs on complex member situations.
Own the daily clinical audit of the Transitions of Care (TOC) queue, utilizing health plan guidelines to appropriately triage complex Level 2 cases and route clean Level 1 referrals to the CHW team.
Identify members whose needs exceed the CHW scope and step in directly or coordinate the appropriate clinical hand-off.
Lead and represent the organization in monthly joint Level 1 and Level 2 case conferences with health plan clinical leadership.
Coach and mentor CHWs to strengthen engagement skills, recognition of behavioral health and risk indicators, and appropriate escalation.
Oversee the end-to-end Medicaid claims cycle for the clinical team, including pre-submission documentation reviews, code utilization tracking, and denial management.
Identify and execute direct-billing opportunities for licensed behavioral health interventions and assessments allowable under Nevada Medicaid.
Help develop and reinforce team workflows, clinical protocols, and best practices in partnership with leadership.
Conduct biopsychosocial and behavioral health assessments to identify member needs, strengths, and risks.
Provide brief, evidence-based clinical intervention (such as motivational interviewing and solution-focused techniques) and warm hand-offs to ongoing behavioral health treatment.
Contribute clinical expertise to individualized care plans as part of the interdisciplinary care team (ICT).
Apply trauma-informed and culturally responsive practice across a diverse, predominantly Medicaid population.
Serve as the team's escalation point for members presenting with behavioral health, safety, or crisis concerns.
Conduct risk assessment and coordinate appropriate crisis response, follow-up, and linkage to emergency or stabilization services.
Support CHWs through difficult situations in the field and debrief afterward.
Partner with CHWs to connect members to behavioral health services, community resources, and supports addressing social determinants of health, including housing, food, transportation, employment, and benefits.
Build and maintain relationships with community-based organizations and behavioral health providers across the assigned territory.
Coordinate with PCPs, care managers, and health-plan partners to close gaps in care.
Maintain timely, accurate clinical documentation in the care management platform.
Ensure work meets Medicaid, state, NCQA, and organizational clinical and privacy (HIPAA) standards.
Contribute to quality initiatives and outcome tracking for the team.
Other duties as assigned

Requirements

What you’ll need

Active, unrestricted Nevada license in one of the following: Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), or Licensed Mental Health Counselor (LMHC).
Degree appropriate to your licensure (for example, ASN or BSN for nursing, MSW for LCSW, master's in counseling for LMHC).
Prior case management, hospital, discharge planning, or care coordination experience strongly preferred.
Case Management Certification (for example, CCM) is preferred.
3+ years of post-licensure clinical or case management experience, including assessment and, where applicable to your scope, crisis intervention.
Experience working with Nevada Medicaid, underserved, or community-based populations.
Demonstrated experience with Medicaid documentation, billing workflows, or CPT/HCPCS coding within an integrated care or care management setting is a plus.
Strong knowledge of social determinants of health and community resource navigation.
Ability to work effectively alongside CHWs and interdisciplinary teams as a non-supervisory clinical resource.
Comfort with community/field-based work and telehealth; valid driver's license and reliable transportation if field travel is required.
Managed care, care management, or integrated behavioral health experience preferred.
Familiarity with local community resources and the regional behavioral health landscape.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Activate Care Website LinkedIn All Job Openings 51 - 200 employees Activate Care is a nationally-recognized provider of social risk management solutions. Path Assist from Activate Care is designed to improve community health outcomes by proactively screening populations for social needs and utilizing our community health navigators interventions leading to better outcomes. Clinical Case Manager Job not on LinkedIn 🔥 57 minutes ago 🏢🏡 Las Vegas – Hybrid ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Serve as the embedded clinical resource for a team of CHWs
Provide real-time case consultation, clinical guidance, and side-by-side assistance to CHWs on complex member situations.
Own the daily clinical audit of the Transitions of Care (TOC) queue, utilizing health plan guidelines to appropriately triage complex Level 2 cases and route clean Level 1 referrals to the CHW team.
Identify members whose needs exceed the CHW scope and step in directly or coordinate the appropriate clinical hand-off.
Lead and represent the organization in monthly joint Level 1 and Level 2 case conferences with health plan clinical leadership.
Coach and mentor CHWs to strengthen engagement skills, recognition of behavioral health and risk indicators, and appropriate escalation.
Oversee the end-to-end Medicaid claims cycle for the clinical team, including pre-submission documentation reviews, code utilization tracking, and denial management.
Identify and execute direct-billing opportunities for licensed behavioral health interventions and assessments allowable under Nevada Medicaid.
Help develop and reinforce team workflows, clinical protocols, and best practices in partnership with leadership.
Conduct biopsychosocial and behavioral health assessments to identify member needs, strengths, and risks.
Provide brief, evidence-based clinical intervention (such as motivational interviewing and solution-focused techniques) and warm hand-offs to ongoing behavioral health treatment.
Contribute clinical expertise to individualized care plans as part of the interdisciplinary care team (ICT).
Apply trauma-informed and culturally responsive practice across a diverse, predominantly Medicaid population.
Serve as the team's escalation point for members presenting with behavioral health, safety, or crisis concerns.
Conduct risk assessment and coordinate appropriate crisis response, follow-up, and linkage to emergency or stabilization services.
Support CHWs through difficult situations in the field and debrief afterward.
Partner with CHWs to connect members to behavioral health services, community resources, and supports addressing social determinants of health, including housing, food, transportation, employment, and benefits.
Build and maintain relationships with community-based organizations and behavioral health providers across the assigned territory.
Coordinate with PCPs, care managers, and health-plan partners to close gaps in care.
Maintain timely, accurate clinical documentation in the care management platform.
Ensure work meets Medicaid, state, NCQA, and organizational clinical and privacy (HIPAA) standards.
Contribute to quality initiatives and outcome tracking for the team.
Other duties as assigned 🎯 Requirements
Active, unrestricted Nevada license in one of the following: Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), or Licensed Mental Health Counselor (LMHC).
Degree appropriate to your licensure (for example, ASN or BSN for nursing, MSW for LCSW, master's in counseling for LMHC).
Prior case management, hospital, discharge planning, or care coordination experience strongly preferred.
Case Management Certification (for example, CCM) is preferred.
3+ years of post-licensure clinical or case management experience, including assessment and, where applicable to your scope, crisis intervention.
Experience working with Nevada Medicaid, underserved, or community-based populations.
Demonstrated experience with Medicaid documentation, billing workflows, or CPT/HCPCS coding within an integrated care or care management setting is a plus.
Strong knowledge of social determinants of health and community resource navigation.
Ability to work effectively alongside CHWs and interdisciplinary teams as a non-supervisory clinical resource.
Comfort with community/field-based work and telehealth; valid driver's license and reliable transportation if field travel is required.
Managed care, care management, or integrated behavioral health experience preferred.
Familiarity with local community resources and the regional behavioral health landscape. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Manager, Strategy and Corporate Development 🕒 June 19 Aristocrat 5001 - 10000 🎮 Gaming Website LinkedIn All Job Openings Manager of Strategy and Corporate Development defining global strategy and corporate vision at Aristocrat. Contributing to long-range planning and engaging in M&A processes across the gaming industry. 🏢🏡 Las Vegas – Hybrid 💵 $98k - $182k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager 🦅 H1B Visa Sponsor Contract Pipeline Manager 🕒 June 9 Libra Solutions 201 - 500 💸 Finance Website LinkedIn All Job Openings Contract Pipeline Manager responsible for end-to-end sales pipeline management for Medical Providers. Collaborating with cross-functional teams to enhance provider onboarding and contract execution. 🏢🏡 Las Vegas – Hybrid ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager YouTube Manager 🕒 June 3 Acquisition.com 11 - 50 📚 Education 🤝 B2B 🏢 Enterprise Website LinkedIn All Job Openings YouTube Manager overseeing content packaging and performance analytics for Acquisition.com brands. Driving strategic direction and optimization of YouTube channels with proven results. 🏢🏡 Las Vegas – Hybrid 💵 $80k - $95k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager Clinical Services Manager 🕒 May 15 DaVita Kidney Care 10,000+ employees ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Clinical Services Manager overseeing safety readiness in clinics across DaVita's facilities. Supporting teams in performance improvement and ensuring compliance with regulatory standards. 🏢🏡 Las Vegas – Hybrid 💰 Post-IPO Debt on 2021-02 ⏰ Full Time 🟢 Junior 🟡 Mid-level 👔 Manager Senior Manager, Reporting 🕒 April 11 Aristocrat 5001 - 10000 🎮 Gaming Website LinkedIn All Job Openings Senior Manager Reporting ensuring financial reporting accuracy and compliance with accounting standards. Leading a high-performance team in a hybrid environment addressing technical accounting support and regulatory compliance. 🏢🏡 Las Vegas – Hybrid 💵 $138.8k - $257.7k / year ⏰ Full Time 🟠 Senior 👔 Manager 🦅 H1B Visa Sponsor View More Manager Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

Clinical AuditCrisis InterventionBiopsychosocial AssessmentMotivational InterviewingSolution-Focused TechniquesCPT/HCPCS CodingCare CoordinationDocumentation ReviewBehavioral Health InterventionCommunity Resource Navigation

Soft Skills

CoachingMentoringCollaborationCommunicationProblem-Solving

Certifications

Case Management Certification (CCM)