Bilingual Case Manager

Division: Health Services • Reports to: Director of Value-Based Care / VP Health Services

About the Role

The case manager oversees complex patient cases, provides expert care coordination, and drives quality outcomes. This role assesses patient needs, develops and implements care plans, and collaborates with healthcare teams to ensure seamless transitions and optimal care with a focus on disease management.

Responsibilities

• Conduct comprehensive patient assessments to identify needs and develop individualized care plans.
• Collaborate with healthcare providers, families, and stakeholders to coordinate care and services.
• Develop and implement disease management plans for patients with chronic conditions (e.g., diabetes, hypertension, asthma/COPD, heart failure, CKD).
• Actively participate in census management, identifying patients with high utilization patterns.
• Identify root causes of admissions and develop targeted interventions to mitigate risk.
• Create and execute plans of care to address needs and prevent future admissions.
• Analyze data and metrics to inform care decisions and drive outcomes.
• Lead or participate in care planning meetings and case conferences.
• Provide education and support to patients and families on care plans, self-management strategies, and disease management progress.
• Identify and address barriers to care, escalating issues as needed.
• Stay up to date on regulatory requirements, best practices, and industry trends in disease management.
• Mentor or supervise junior care coordinators.
• Participate in quality improvement initiatives and special projects.

Requirements

• 5 years of medical experience.
• Foreign MD license or Foreign RN license.
• Medical Assistant with more than 10 years of care coordinator experience or LPN Florida License.
• Knowledge of medical terminology, CPT, HCPCS, and ICD coding preferred.
• Bilingual (English/Spanish) is a plus.

Skills

• Detail-oriented with strong multi-tasking and problem-solving abilities.
• Open to cross-functional training.
• Proficient in phone etiquette and computer software systems.
• Team-oriented, professional, and courteous when working with patients, colleagues, physicians, and other personnel.
• Exceptional organizational skills with the ability to prioritize and complete tasks in a timely manner.

Physical & Mental Requirements

• Ability to stand or sit for extended periods of time.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to use logical reasoning for simple and complex problem solving.
• Occasionally requires exposure to communicable diseases or bodily fluids.
• Occasional travel for clinic activities may be required.