Case Manager

CCN Pharmacy; Pittsburgh (Allegheny County); On-site; USD 52,000 - 78,000; Full time

Job summary

CCN Pharmacy is seeking a Case Manager to provide comprehensive support by assessing, planning, and coordinating care across pharmacy, clinical, and community settings. You will serve as liaison between patients, providers, referral agencies, and internal teams to promote adherence and improve outcomes.

Responsibilities include conducting new assessments, developing individualized care plans, linking patients to medical and social services, documenting activities, and ensuring compliance with

Qualifications

• Bachelor’s degree in social work, psychology, sociology, or a related field.
• At least two (2) years minimum case management experience.
• Experience in resource coordination, including identifying, accessing, and connecting patients to medical, behavioral health, and community support services.

Responsibilities

• Assess patients and conduct reassessments, ensuring documentation is complete and on time.
• Develop individualized care plans linking patients to medical, behavioral health, and social services.
• Coordinate with outside agencies and providers to maintain access to benefits and resources.
• Collaborate with Pharmacy staff to ensure timely prescription management and access.
• Monitor patient progress and update care plans; ensure compliance with policies.

Skills

Communication

Time management

Organizational skills

Detail oriented

Independence

Team player

Problem solving

Decision making

MS Office

Education

Bachelor's degree in social work/psychology/sociology/related field

Tools

Word

Excel

Access

Job description

Position Summary

The Case Manager provides comprehensive support to patients by conducting assessments, developing individualized care plans, coordinating access to medical and social services, and ensuring continuity of care across pharmacy, clinical, and community settings. This role serves as a liaison between patients, providers, referral agencies, and internal pharmacy teams to promote adherence, improve health outcomes, and remove barriers to care. The Case Manager maintains detailed documentation, monitors patient progress, and ensures all case management activities align with program policies and regulatory requirements.

Essential Functions & Responsibilities

Assessment & Care Planning

• Schedule and conduct new assessments and reassessments, ensuring all documentation is completed accurately and on time.
• Conduct comprehensive health risk and medication assessments for identified patients.
• Complete additional assessments as indicated by disease state or program requirements.
• Develop individualized care plans based on assessment findings, linking patients to appropriate medical, behavioral health, and social services.
• Schedule follow‑up with patients to ensure linked resources were effective and update care plans as needed.

Care Coordination & Resource Navigation

• Provide patients with knowledge of Medicaid managed care, available resources, provider access pathways, and the benefits of specialized pharmacy programs.
• Coordinate with outside agencies, including the Department of Public Welfare to ensure patients maintain access to medical benefits.
• Develop working relationships with referral agencies and community partners to support patient needs.
• Collaborate closely with Pharmacy staff to ensure timely management of prescription needs and medication access.
• Act as a liaison with medical providers to support continuity of care and resolve barriers.
• Maintain a detailed electronic and written database of resources to support patient referrals and care planning.

Monitoring & Documentation

• Monitor the effectiveness of care plans and patient progress, updating annually during reassessment or sooner if indicated.
• Provide copay assistance support by identifying eligible programs, completing required documentation, coordinating with manufacturers and foundations, and guiding patients through enrollment to reduce out‑of‑pocket costs.
• Maintain accurate, timely, and comprehensive documentation of all patient interactions, assessments, referrals, and care coordination activities.
• Implement and adhere to all case management program policies and procedures.

Other Responsibilities

• Perform all other duties as assigned by the Supervisor.

Education & Experience Requirements

• Bachelor’s degree in social work, psychology, sociology, or a related field.

Preferred Qualifications

• At least two (2) years minimum case management experience.
• Experience in resource coordination, including identifying, accessing, and connecting patients to medical, behavioral health, and community support services.

Skills & Competencies

• Strong written and verbal communication skills and an ability to work with people from diverse backgrounds.
• Comprehend written sentences and paragraphs in work related documents.
• Excellent time management and organizational skills.
• Detail oriented and able to multitask.
• Ability to work independently, efficiently, and proactively.
• Active demonstration of team player qualities: collaborative, flexible, dependable, accountable, solution oriented, and respectful of others.
• Knowledge and experience working in Word, Excel, and Access.
• Strong problem‑solving and decision‑making skills.

Physical Requirements / Working Conditions / Behavioral Expectations

• Ability to use telephones, computers, designated software, MS Office applications, printers, calculators, fax machines, and other pharmacy equipment.
• Ability to walk, stand, sit, and reach frequently throughout the workday.
• 0% travel required.
• Ability to work independently and collaboratively within a team environment.
• Presents a professional, reliable, and positive image, demonstrating competence, self‑control, honesty, and appropriate appearance.
• Demonstrates respect, appreciation, and sensitivity toward the needs and dignity of all people.
• Maintains a safe, clean, and professional work environment and contributes to overall organizational safety and professionalism.