Clinical Case Manager Job Description

clinical case manager job description includes a detailed overview of the key requirements, duties, responsibilities, and skills for this role.

Last update : July 14, 2023

Clinical Case Manager Job Description

A clinical case manager (CCM) is a health care professional who provides care for people living with a chronic illness.

A CCM coordinates and facilitates care between a patient and various health care professionals, government agencies, community resources, and the patient’s family.

The clinical case manager cares for patients across various levels of care, including primary and acute, long-term, and post-acute care.

The clinical case manager’s primary goal is to improve patients’ quality of life, function, and independence.

Job Brief:

We’re looking for a Clinical Case Manager who can help us provide the best possible care for our patients. The Clinical Case Manager will be responsible for coordinating care between different medical professionals, making sure that each patient’s needs are being met.

Clinical Case Manager Duties:

  • Bring in new clients and maintain current clients’ satisfaction by providing assessments and follow-up referrals
  • Liaise with interdisciplinary teams to develop and implement treatment plans
  • Provide emotional support and counseling to clients
  • Provide referrals to community resources
  • Establish and maintain effective communication with patients and their families
  • Correct any inconsistencies that may arise
  • Review existing treatment plans and revise as needed
  • Improve and refine treatment plans and treatment plans
  • Maintain appropriate documentation of care
  • Develop and maintain effective working relationships with multidisciplinary teams, patients, their families, and other healthcare professionals
  • Research, identify, and implement new evidence-based interventions

Clinical Case Manager Responsibilities:

  • Develop and maintain a network of connections to local mental health care providers at every stage of the treatment process, from initial assessment to ongoing therapy
  • Meet with patients to assess their mental health needs, make referrals for appropriate services, and provide ongoing clinical support
  • Underwrite and coordinate the claims administration process, including reviewing, processing, and resolving claims
  • Work closely with in-house legal counsel to resolve legal claims, and resolve payor contract disputes
  • Manage all aspects of billing and collection, and review and approve invoices to ensure compliance with contractual terms
  • Maintain and update billing/collections database
  • Utilize knowledge and expertise in the claims and collection processes to effectively manage the therapy and disability claims process
  • Maintain and update claimant records
  • Work closely with scheduling department to update and process workers’ compensation claims
  • Manage all aspects of appeals
  • Implement quality controls, and achieve high levels of customer satisfaction and retention

Requirements And Skills:

  • Bachelor’s degree in social work, psychology, or related field
  • 2+ years’ experience working as a case manager
  • Outstanding organizational skills, including the ability to multi-task effectively
  • Excellent communication and human relations skills
  • Knowledge of case management methods and processes
  • Ability to maintain confidentiality

[Company Name] is proud to be an Equal Opportunity Employer. We believe that diversity and inclusion are essential to our success as a company. We are committed to building a team that reflects our values of diversity and inclusion. We encourage applications from people of all races, religions, national origins, genders, and ages, as well as veterans and individuals with disabilities.

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