Clinical Case Manager

capitalhealth; Tallahassee (FL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health coverage

Dental insurance

HSA/Dependent care spending accounts

Short and long-term disability

MDTO (Major disability time off)

Retirement plan

Life and AD&D insurance

Voluntary life and AD&D

Paid time off

Employee assistance program

SmartDollar

Job summary

Capital Health Plan in Tallahassee, FL is seeking a licensed healthcare professional for a full-time Clinical Case Manager to coordinate high-quality care for members with complex health needs. You will assess needs, develop care plans, and collaborate with physicians and care teams.

You will connect members with resources, monitor progress, and drive improvements in outcomes and efficiency while upholding quality standards and regulatory guidelines.

Qualifications

• Bachelor's degree or equivalent combination of education and related experience.
• Licensed Medical Professional.
• CCM certification or ability to obtain within 12 months of hire.
• Strong communication, problem-solving, and care coordination skills.
• Ability to manage complex, chronic, and/or catastrophic medical cases.
• Knowledge of medical coding, regulatory guidelines, and evidence-based clinical practices.
• Proficiency with Microsoft Office applications.
• Ability to read, interpret scientific/technical journals, financial reports, and legal documents.
• Ability to effectively present information to top management, public groups, and/or boards of directors.
• Strong math skills.

Responsibilities

• Assess healthcare needs and develop personalized care plans.
• Collaborate with physicians and multidisciplinary care teams.
• Connect members with resources to help achieve health goals.
• Identify opportunities to improve outcomes, remove barriers to care, monitor progress.
• Use clinical expertise to ensure interventions support quality and efficiency.

Skills

Communication skills

Problem-solving

Care coordination

Education

Bachelor's degree

CCM certification

Job description

Are you a licensed healthcare professional with a passion for improving outcomes, coordinating complex care, and helping individuals achieve their healthiest lives? Capital Health Plan is seeking a dedicated Clinical Case Manager to join our team in Tallahassee, FL. In this full-time role, you'll leverage your clinical expertise, leadership skills, and commitment to quality care to support members with complex healthcare needs while contributing to an organization recognized for excellence, compassion, and innovation.

Pay: We offer our Clinical Case Manager a competitive wage.

Benefits:

• Health coverage and dental insurance
• Health and dependent care spending accounts
• Short and long-term disability
• Major disability time off (MDTO)
• Retirement plan
• Life and AD&D insurance
• Voluntary life and AD&D insurance
• Paid time off (PTO)
• Employee assistance program
• SmartDollar

CAPITAL HEALTH PLAN: OUR MISSION

We are a not-for-profit health care organization that has served the panhandle since 1982, delivering high-quality, affordable, and patient-centered care. Our employees are essential to our continued success, and their passion, motivation, and commitment drive our reputation for excellence and member satisfaction.

Whether delivering direct care, supporting patients, or ensuring smooth operations behind the scenes, every team member plays a vital role in fulfilling our mission to improve the health of our communities. We are dedicated to fostering a professional, respectful, and inclusive workplace where employees are valued, supported in their growth, and empowered to make a meaningful impact.

YOUR DAY

As our full-time Clinical Case Manager, you'll serve as the driving force behind coordinated, high-quality care for a designated panel of members. Each day, you'll assess healthcare needs, develop personalized care plans, collaborate with physicians and multidisciplinary care teams, and connect members with valuable resources that help them achieve their health goals. You'll identify opportunities to improve outcomes, remove barriers to care, monitor progress, and use your clinical expertise to ensure every intervention supports both quality and efficiency.

REQUIREMENTS

• Bachelor's degree or equivalent combination of education and related experience
• Licensed Medical Professional
• Current Certified Case Manager (CCM) certification or able to obtain within 12 months of hire
• Strong communication, problem-solving, and care coordination skills
• Ability to manage complex, chronic, and/or catastrophic medical cases
• Knowledge of medical coding, regulatory guidelines, and evidence-based clinical practices
• Proficiency with Microsoft Office applications
• Ability to read, interpret common scientific and technical journals, financial reports, and legal documents
• Ability to effectively present information to top management, public groups, and/or boards of directors
• Strong math skills

ARE YOU READY FOR THIS EXCITING OPPORTUNITY?

Join Capital Health Plan and become part of a team dedicated to delivering exceptional care, improving outcomes, and supporting healthier communities. Our initial application process is quick, simple, and mobile-friendly.

CHP is proud to be an Equal Opportunity Employer and is committed to maintaining a workplace that values professionalism, integrity, and respect. We provide equal employment opportunities to all employees and applicants and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status.