Managed Care Case Manager: Care Coordination Pro

Legacy Health Services; Parma (OH); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Comprehensive benefits

401(k) with company match

Education opportunities

Job summary

Legacy Health Services is seeking a detail‑oriented Managed Care Case Manager to coordinate post‑acute care, liaise with payors, physicians, and care teams, and ensure cost‑effective care. The role supports transitions, utilization review, and optimal patient outcomes.

The ideal candidate has a healthcare degree or licensed clinical credential, 2+ years in healthcare, and 1+ year in case management. Proficiency in Microsoft Office and strong negotiation skills are valued.

Qualifications

• Bachelor’s degree in healthcare or related field or a licensed clinical degree.
• 2+ years of experience in a healthcare setting.
• At least 1 year of Case Management experience preferred.
• Strong knowledge of workers’ compensation, insurance, and managed care.
• Exceptional verbal and written communication skills.
• Strong problem-solving, negotiation, conflict-resolution, and time-management skills.
• Proficiency with Microsoft Office (Word, Excel, PowerPoint).

Responsibilities

• Maintain working knowledge of all managed care contracts within assigned areas.
• Negotiate levels of care with contracted and non-contracted payors.
• Coordinate patient transitions and communicate discharge plans to interdisciplinary teams.
• Obtain and verify clinical and discharge information from physicians, patients, and payors.
• Complete timely reviews, authorizations, and documentation within MCO portals.
• Serve as primary contact for care coordination throughout the continuum of care.
• Participate in interdisciplinary discussions to support care planning and monitor progress.
• Educate and train new team members on contract terms and case management processes.
• Communicate insurance coverage and benefits to patients and families as needed.
• Assist with billing reviews, collections support and appeals as appropriate.
• Ensure patient confidentiality and HIPAA compliance.
• Participate in monthly P&L reviews and support quality improvement initiatives.
• Attend required trainings, orientations, and key account meetings.
• Provide coverage for other Case Managers as needed.
• Model customer service principles and support the organization’s mission and values.

Skills

Case management

Verbal communication

Written communication

Negotiation

Time management

Education

Bachelor's degree in healthcare or related field

Licensed clinical degree

Tools

Microsoft Office

Job description

Legacy Health Services is seeking a detail‑oriented Managed Care Case Manager to coordinate post‑acute care, liaise with payors, physicians, and care teams, and ensure cost‑effective care. The role supports transitions, utilization review, and optimal patient outcomes.

The ideal candidate has a healthcare degree or licensed clinical credential, 2+ years in healthcare, and 1+ year in case management. Proficiency in Microsoft Office and strong negotiation skills are valued.