About the Role
Remote Pediatric Case Manager Role!
Job Description
The Pediatric Case Manager plays a crucial role in managing complex and chronic conditions within a pediatric population in a managed care environment. This position collaborates with providers, hospitals, and multidisciplinary teams to coordinate care, close gaps, and enhance health outcomes while minimizing avoidable utilization.
Responsibilities
+ Conduct comprehensive needs assessments and stratify risk.
+ Develop individualized care plans aligned with evidence-based guidelines.
+ Review inpatient census activity and coordinate discharges.
+ Conduct outreach to high-risk members and provide disease-specific education.
+ Empower patients and families in self-management.
+ Operate in compliance with Medicaid requirements and PCMH standards.
+ Support cost-effective care delivery and improve members' quality of life.
Essential Skills
+ Active Fl...
Job Description
The Pediatric Case Manager plays a crucial role in managing complex and chronic conditions within a pediatric population in a managed care environment. This position collaborates with providers, hospitals, and multidisciplinary teams to coordinate care, close gaps, and enhance health outcomes while minimizing avoidable utilization.
Responsibilities
+ Conduct comprehensive needs assessments and stratify risk.
+ Develop individualized care plans aligned with evidence-based guidelines.
+ Review inpatient census activity and coordinate discharges.
+ Conduct outreach to high-risk members and provide disease-specific education.
+ Empower patients and families in self-management.
+ Operate in compliance with Medicaid requirements and PCMH standards.
+ Support cost-effective care delivery and improve members' quality of life.
Essential Skills
+ Active Fl...
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