Case Manager at Premier Community Healthcare Grp. – Dade City, Florida

Job Title: Case Manager

Remote

General Description

The Case Manager supports patients with complex, high-risk, or chronic health conditions through coordinated, patient-centered care. This role serves as a liaison between patients, providers, insurance partners, and community resources to ensure continuity of care, reduce barriers, and improve health outcomes. The Case Manager plays a critical role in care coordination, quality initiatives, and patient advocacy.

Essential Duties and Responsibilities

• Manage a caseload of high-risk and high-cost patients with complex medical and social needs
• Identify gaps in care, barriers to treatment adherence, and social determinants impacting health
• Conduct outreach and pre-visit planning to support care coordination and follow-up
• Collaborate with providers, care team members, and insurance partners to ensure continuity of care
• Upload required documentation into insurance portals to meet quality and compliance standards
• Create and analyze reports to monitor high-risk populations and care outcomes
• Coordinate referrals, authorizations, and access to community resources and support services
• Assist with clerical tasks including obtaining medical records, lab results, and consultation notes
• Participate in quality improvement initiatives and required meetings
• Maintain accurate documentation in the Electronic Health Record (EHR)
• Ensure confidentiality and HIPAA compliance at all times
• Represent the organization’s mission, values, and commitment to patient-centered care
• Perform other duties as assigned

Knowledge, Skills, and Abilities

• Basic understanding of medical terminology and healthcare documentation
• Strong organizational, analytical, and problem-solving skills
• Excellent communication skills, both verbal and written
• Ability to work effectively with diverse populations and interdisciplinary teams
• Demonstrates empathy, professionalism, and ethical conduct
• Strong customer service orientation with a patient-first mindset

Qualifications

• Licensed Practical Nurse (LPN) or Associate degree in nursing, social work, or a related field (required)
• Minimum of five (5) years of nursing or healthcare experience
• At least one (1) year of case management or related experience preferred
• Experience with HEDIS, quality metrics, or care coordination preferred
• Current Basic Life Support (BLS) certification preferred
• Ability to obtain and maintain EHR (e.g., Epic) certification and required compliance training

Working Conditions & Physical Requirements

• Ability to sit for extended periods of time
• Ability to lift up to 20 lbs. regularly and 30–50 lbs. occasionally
• Regular exposure to computer screens
• Possible exposure to infectious or contagious disease

Background Screening Requirement:
This position requires a Level 2 background screening through the Florida Agency for Health Care Administration (AHCA) Care Provider Background Screening Clearinghouse.

Applicants may review information regarding the background screening process, disqualifying offenses, and applicant rights by visiting the AHCA Background Screening Education and Awareness webpage:
https://info.flclearinghouse.com