Remote Infusion Programs Case Manager

Capital Rx Inc.; United States; Remote; USD 65,000 - 70,000; Full time

Job summary

Judi Health is seeking a Clinical Programs Case Management Specialist to support site-of-care optimization by engaging members, prescribers, and infusion providers. You will coordinate referrals, educate on infusion options, and ensure timely, high-quality care with internal and external stakeholders.

Responsibilities include documenting activities, tracking referrals, and collaborating across clinical, operational, and account teams to drive program success while maintaining HIPAA compliance.

Qualifications

• 3+ years of experience in a clinical setting, PBM, health plan, or related environment.
• At least 1 year of customer service with strong written and verbal communication.
• Experience working with EMRs and healthcare documentation systems.
• Ability to manage multiple priorities and complex projects independently.
• Familiarity with HIPAA, confidentiality, and data integrity requirements.

Responsibilities

• Coordinate outreach to members, prescribers, pharmacies, and other healthcare stakeholders for site-of-care referrals.
• Educate members on infusion therapy options, site-of-care alternatives, and available support resources.
• Coordinate with members, prescribers, patient coordinators, and care navigators to provide referrals and status updates.
• Serve as a liaison between internal teams, providers, and external partners to address questions and ensure timely service delivery.
• Document outreach attempts and case activities in applicable systems; maintain accurate records.
• Track referral progress and escalations to ensure adherence to service levels and workflows.
• Maintain program resources, including drug lists and workflow materials, through routine reviews.
• Identify barriers impacting member access and escalate issues as needed.
• Support departmental initiatives and other duties as assigned.

Skills

Medical Case Management

EMR Systems

Clinical Experience

Customer Service

Multi-tasking

Reliable Internet

Tools

Microsoft Excel

PowerPoint

Confluence

Jira

Tableau

Salesforce

Job description

Judi Health is seeking a Clinical Programs Case Management Specialist to support site-of-care optimization by engaging members, prescribers, and infusion providers. You will coordinate referrals, educate on infusion options, and ensure timely, high-quality care with internal and external stakeholders.

Responsibilities include documenting activities, tracking referrals, and collaborating across clinical, operational, and account teams to drive program success while maintaining HIPAA compliance.