Specialty Care Manager: Care Coordination & Outcomes

Jobtailor; Connecticut; On-site; USD 75,000 - 95,000; Full time

Job summary

Jobtailor is seeking a skilled care coordinator to manage complex cases and optimize transitions across the continuum of care. You will apply established guidelines to ensure appropriate care levels and coordinate with members, families, and healthcare teams.

The role emphasizes utilization management, documentation, and collaboration with physicians. A strong background in case management and strong communication skills are essential for success in this position.

Qualifications

• Requires RN license or Bachelor degree in social work, health or behavioral science.
• Graduate degree preferred in Social Work or Health and Behavioral Science.
• Minimum of three years of experience serving members with special needs.

Responsibilities

• Perform care coordination using established guidelines to ensure appropriate level of care and transitions.
• Implement interventions for efficient utilization of benefits.
• Assess members' clinical needs against standards.
• Partner with members, families, physicians, and healthcare teams to coordinate resource utilization.
• Set priorities and plan interventions supporting self-care and independence.
• Monitor care activities for appropriateness and effectiveness.
• Consult internal stakeholders on complex cases and elevate to internal physician resources as needed.
• Document accurately according to practice standards and policies.

Skills

Care coordination

Clinical needs assessment

Utilization monitoring

Quality improvement

Variance analysis

Education

Bachelor's degree in social work, health or behavioral science

Graduate degree in Social Work or Health and Behavioral Science

Tools

Microsoft Office

Excel

Access

Word

Job description

Jobtailor is seeking a skilled care coordinator to manage complex cases and optimize transitions across the continuum of care. You will apply established guidelines to ensure appropriate care levels and coordinate with members, families, and healthcare teams.

The role emphasizes utilization management, documentation, and collaboration with physicians. A strong background in case management and strong communication skills are essential for success in this position.