Medical Case Manager

Care Resource; Fort Lauderdale (FL); On-site; USD 45,000 - 60,000; Full time

Job summary

A health service provider is seeking a Medical Case Manager in Fort Lauderdale. The role involves coordinating medical services, enrolling clients in insurance programs, and maintaining treatment plans. Ideal candidates should have a bachelor's degree in a behavioral science field, two years of experience, and a passion for client advocacy. The position offers an on-site work environment with opportunities for community engagement and development.

Qualifications

• Bachelor’s degree in a behavioral science field like social work, nursing, or psychology is required.
• Two years of related experience, including one year of HIV/AIDS experience.
• Affordable Care Act Certified Application Counselor Certificate is required annually.

Responsibilities

• Coordinate assessments and referrals for clients needing various health services.
• Provide outreach and enrollment assistance for health insurance.
• Maintain organized tracking of client treatment plans.

Skills

Client interaction

Assessment coordination

Case management

Effective communication

Knowledge of health insurance

Education

Bachelor’s Degree in Behavioral Science

Tools

Electronic data entry systems

Job description

Location: 871 W Oakland Park, Ft. Lauderdale, FL 33311, USA

• On-site
• Travel Required: No
• Social Services
• Full-Time
• Requisition #: MEDIC002230

Description

Job Summary

The Medical Case Manager is responsible for coordinating the assessment and subsequent referrals/access to medical, dental, mental health/substance abuse care, pharmaceutical access, treatment education, and other services needed by Care Resource clients. S/he assists with signing up individuals for insurances under the Affordable Care Act’s Insurance Exchanges for the State of Florida, provides education to potentially insured clients and utilizes tools specifically designed to select the best coverage based upon individual's current medical profile including preferred providers, medications, co-pays, deductibles and premiums.

Medical Caseload Management

Provides outreach and enrollment assistance activities and facilitates enrollment of eligible health center patients and service area residents into affordable health insurance coverage through the Health Insurance Marketplaces, Medicaid, or the Children’s Health Insurance Program.

Interaction with clients leads to improved client health.

Creates rapport within client interaction to help each progress in their medical treatment.

Interviews prospective clients to determine individual needs and eligibility for various medical and social services, enrolling them into available community programs.

Coordinates, supports and follows up on medical treatments.

Maintains an average annual active caseload as assigned by the supervisor.

Serves as a liaison, coordinator and/or advocate between various co-workers within the Case Management, Medical Care departments or other community medical or agency service provider to remove barriers to treatment/care for clients.

Uses knowledge of individual programs to conduct home visits, hospital visits and one visit with the State of Florida’s contracted disease management firm to develop acuity level of care as needed.

Coordinates with physicians for appropriate service mobilization.

Discharge planning from hospitalizations that coordinates post hospital care based upon client needs.

Maintains organized systems of tracking client labs, medication, diagnostic testing, medical, therapy and hospital visits to help clients remain compliant with treatment and service plans; all with the goal of seeing clients progress toward improvements in their lives.

Provides ongoing medication and treatment counseling through use of treatment adherence assessment tools.

Treatment – Service Planning and Documentation

Ensures all documentation is Timely, Accurate, Legible and Clear.

Develops comprehensive, individualized service plans or plans of care.

Monitors clients to assess efficacy of treatment plans and re‑assesses and adjusts as necessary.

Empowers clients to participate in their treatment planning.

Maintains treatment plans, progress notes and progress reviews in client records as specified in agency policy, program guidelines and performance standards.

Input client information using electronic data entry according to agency and departmental guidelines.

Maintains an accurate record on time sheet reflecting time spent in each program worked (e.g. Ryan White 75 hrs, Medicaid Waiver 5 hrs, ACA 10 hrs).

Prepares necessary program reports and records as requested by the supervisor and/or manager.

Coordinates with supervisor when necessary to meet unusual challenges.

Manages Resources

Maintains comprehensive knowledge of community services to apply knowledge of services to individual client needs.

Utilizes knowledge of community programs to help clients understand the different types of medical, insurance and other programs offered under State and Federal Programs as required.

Bills a minimum of six hours in an 8-hour day.

Uses program knowledge to provide clients with information about bill‑coverage, services and procedures as required.

Controls, manages, and balances, monthly, the annual budget stipulated by the State of Florida for each appropriate client.

Supports billing through concurrent documentation of service provided and budget activities as required (i.e. reconciling billing across data systems including: PCIS, Web‑based systems, CASEWATCH and client records).

Participates in staff training sessions within the timeframes specified and as required by the agency and the funding source.

Community Involvement

Participates in agency developmental activities as requested.

Other duties as assigned.

Safety

Ensure proper hand washing according to Centers for Disease Control and Prevention guidelines.

Documents patient’s medications correctly, makes sure each patient knows which medicines to take when they are at home and encourages each patient to bring their up‑to‑date list of medicines every time they visit the doctor.

Ensure each new client receives screening for their risk of suicide.

Understands and appropriately acts upon assigned role in Emergency Code System.

Understands and performs assigned role in Agency Continuity of Operations Plan (COOP).

Job Specifications

Education

Bachelor’s Degree in a behavioral science field like Social Work, Nursing or Psychology is required.

Training and Experience

Two (2) years of related experience are required. One year of HIV/AIDS experience is required. HIV/AIDS 104, 500 & 501 and Case Management training provided by the State or County are required within 90 days of hire date.

Licenses and/or certifications

Affordable Care Act Certified Application Counselor Certificate required annually. Case Management Medicaid Provider Certification is required. Completed application and fingerprinting submitted to supervisor within 30 days of hire.

Contact Responsibility

The responsibility for internal and external contacts is frequent and important.

Culture of Service: 3 C’s

Compassion

Greets internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone and nonverbal language.

Listens to the internal or external customer (i.e. patient, client, staff, vendor) attentively, reassuring and understanding of the request and providing appropriate options or resolutions.

Competency

Provides services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered.

Commitment

Takes initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed. Prioritize internal or external customer requests to ensure the prompt and effective response is provided.

Safety

Ensures proper handwashing according to the Centers for Disease Control and Prevention guidelines.

Understands and appropriately acts upon the assigned role in Emergency Code System.

Understands and performs assigned roles in the organization’s Continuity of Operations Plan (COOP).

Physical Requirements

This work requires the following physical activities: constant sitting, walking, hearing, talking in person and talking on the phone. Occasional driving stretching/reaching and standing are required. Work is performed in an office setting. Sometimes, work is performed in client’s homes, community agency settings and in hospitals.

Other

Participates in health center developmental activities as requested. Other duties as assigned. Own transportation required.

Desired Attributes

Enthusiastic: Shows intense and eager enjoyment and interest.

Dedicated: Devoted to a task or purpose with loyalty or integrity.

Team Player: Works well as a member of a group.

Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well.

Motivations

Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals.

Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization.

Legal Compliance Notice

Legal Compliance Notice: This careers website is maintained by Care Resource Community Health Centers, Inc. a qualified entity, in support of compliance with House Bill 531 (2025). As required by law, Care Resource includes a clean and conspicuous link to this resource on its website and provides the link in all job vacancy advertisements and postings issued by the health center. For more information, please see the link to the new Care Provider Background ScreeningClearinghouse Education and Awareness website.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.