Job Description

Job Title: Case Manager I

Location: Clark County or Madison County, OH (Remote + Field Visits)

Duration: 3 Months (Possible Extension)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM EST

Position Overview:

• This is a remote position requiring occasional home visits (0–3 per week) for members in the Waiver population.
• The role focuses on case management, assessments, and care planning to ensure members receive quality, cost-effective care in compliance with regulations.
• Location for home visits: Clark County or Madison County, OH

Day-to-Day Responsibilities:

• Conduct telephonic and in-person visits with members receiving home care services.
• Assess member needs, develop care plans, and authorize appropriate services.
• Monitor care plan effectiveness and update as needed.
• Collaborate with members, caregivers, physicians, and providers.
• Maintain accurate documentation and meet productivity/quality standards.

Essential Functions:

• Provide case management for members with chronic/complex conditions.
• Conduct assessments and implement individualized care plans.
• Coordinate services, including behavioral health and long-term care.
• Participate in interdisciplinary team meetings and ongoing training.
• Ensure compliance with HIPAA, company policies, and state/federal regulations.

Required Education/Certification:

• RN, LSW, or LISW – must be licensed in Ohio

Required Experience:

• Minimum 1 year case management or managed care experience
• Minimum 1 year working with individuals with chronic conditions/home care

Skills & Abilities:

• Strong assessment, organizational, and problem-solving skills
• Ability to work independently and manage multiple priorities
• Proficient in Microsoft Office and case management tools
• Knowledge of applicable regulations, coding (ICD-9, CPT, HCPC), and benefits coordination
• Excellent verbal and written communication skills
• Ability to maintain professional relationships with members, providers, and team members

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