Healthcare - Case Manager III

Company : LanceSoft Inc
Location : San Diego, CA
Posted Date : 16 October 2025
Job Type : Other
Category : Community & Social Service
Occupation : Case Manager
Job Details
Location: San Diego area (CA State)
Duration: 3+ Months
Shift Timing: Monday through Friday, 8:30AM to 5:30PM PST
Pay Range: $45.00 - $47.26
Job Description:
- Will this role be fully remote? It will be remote, but there may be times the CM may need to work in the office or make visits to see members in-person. It's very minimal at this time, but could happen.
- What is the expected schedule (include dates/time): Monday through Friday, 8:30AM to 5:30PM PST
- What are the day to day job duties? CMs will need to outreach to members assigned to them, complete various assessments, create individualized care plans, assist members with community resources/linkages.
- Top Skills Required: Strong computer skills as this job requires being able to navigate different systems; organization as there is a lot of work and very independent; health literacy - as this position is for a CM so they will need to be able to assess/understand different physical and mental health diagnoses/symptoms and educate members
- Required Education/Certification(s): RN
- Required Years of Experience: Prefer 3, but open to someone with less years, depending on what work they have been doing
- What extra equipment is required? dual monitors, docking station
- Is there potential for this to extend past 3 months or convert to an FTE? There is potential to convert to FTE
- Responsible for health care management and coordination of Client Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care.
- Coordinates and monitors Clientmember's progress and services to ensure consistent cost effective care that complies with Client policy and all state and federal regulations and guidelines.
- Provides case management services to members with chronic or complex conditions including.
- Proactively identifies members that may qualify for potential case management services.
- Conducts assessment of member needs by collecting in-depth information from Client information system, the member, member's family/caregiver, hospital staff, physicians and other providers. o Identifies, assesses and manages members per established criteria.
- Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. o Performs ongoing monitoring of the plan of care to evaluate effectiveness.
- Documents care plan progress in Client information system. o Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. o Measures the effectiveness of interventions to determine case management outcomes.
- Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for Client members. • Conducts face to face or home visits as required.
- Maintains department productivity and quality measures.
- Manages and completes assigned work plan objectives and projects in a timely manner.
- Demonstrates dependability and reliability. • Maintains effective team member relations. • Adheres to all documentation guidelines.
- Participates in Interdisciplinary Care Team (ICT) meetings.
- Assists orientation and mentoring of new team members as appropriate.
- Maintains professional relationships with provider community and internal and external customers.
- Conducts self in a professional manner at all times.
- Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct. • Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth. • Complies with required workplace safety standards. Knowledge/Skills/Abilities: • Demonstrated ability to communicate, problem solve, and work effectively with people.
- Excellent organizational skill with the ability to manage multiple priorities. • Work independently and handle multiple projects simultaneously.
- Knowledge of applicable state, and federal regulations.
- Knowledge of ICD-9, CPT coding and HCPC. • SSI, Coordination of benefits, and Third Party Liability programs and integration.
- Familiarity with NCQA standards, state/federal regulations and measurement techniques.
- In depth knowledge of CCA and/or other Case Management tools. • Ability to take initiative and see tasks to completion. • Computer skills and experience with Microsoft Office Products.
- Excellent verbal and written communication skills. • Ability to abide by Client policies. • Able to maintain regular attendance based upon agreed schedule.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.
- Bachelor's degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree).
- 5-7 years of clinical experience with case management experience.
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