Care Management Clinician

PacificSource Health Plans

Care Management Clinician facilitating client wellness through assessment and resource management at PacificSource. Collaborating with healthcare providers for effective service delivery and care coordination.

Posted 7/3/2026full-timeWFH • Florida • 🇺🇸 United StatesMid-LevelSenior💰 $70,950 - $106,424 per yearWebsite

About the role

Key responsibilities & impact

Clinician Care Managers facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation
Collect and assess patient information pertinent to patient’s history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services
Based on the needs and values of the client, and in collaboration with all service providers, the clinician links clients with appropriate providers and resources throughout the continuum of health and human services and care settings
Ensure that the care provided is safe, effective, client-centered, timely, efficient, and equitable
Clinicians have direct communication among the client, the payer, the primary care provider, and other service delivery professionals
Interact with other PacificSource personnel to assure quality customer service is provided
Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies
Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients
Practice and model effective communication skills: both written and verbal
Utilize and promote use of evidence-based tools
Utilize lean methodologies for continuous improvement

Requirements

What you’ll need

Minimum of three (3) years of clinical experience, including case management
Insurance industry experience preferred
Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required
Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) also required at time of hire or within two years of hire date
Knowledge of health insurance and state mandated benefits
Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation
Ability to deal effectively with people who have various health issues and concerns
Knowledge and understanding of contractual benefits and options available outside contractual benefits
Knowledge of community services, providers, vendors and facilities available to assist members
Ability to use computerized systems for data recording and retrieval

Benefits

Comp & perks

Flexible telecommute policy
Medical, vision, and dental insurance
Incentive program
Paid time off and holidays
401(k) plan
Volunteer opportunities
Tuition reimbursement and training
Life insurance
Options such as a flexible spending account

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

AdvocacyAssessmentPlanningResource ManagementService FacilitationData RecordingData RetrievalEvidence-Based ToolsLean Methodologies

Soft Skills

Effective CommunicationInterpersonal Skills

Certifications

Registered Nurse (RN) LicenseLicensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)Licensed Clinical Social Worker (LCSW)Certified Case Manager Certification (CCM)