Case Manager

Job Title: Case Manager

Employment Type: Full-Time
Location: Hybrid/Remote

Position Overview

PsynergyHealth is a fast-growing telehealth platform dedicated to revolutionizing virtual care delivery.

We are seeking a dedicated, highly organized Case Manager to oversee patient care journeys from intake through recovery.

In this role, you will serve as the central advocate and clinical coordinator for patients utilizing our remote care services. By collaborating closely with multidisciplinary clinical teams, insurance payers, and community resources, you will build individualized care plans that address both medical and socioeconomic barriers to health. Your clinical background will allow you to assess patient needs accurately, monitor compliance with treatment plans virtually, and prevent unnecessary hospital readmissions, ensuring our patients receive the right care at the right time.

Core Responsibilities

1. Care Coordination & Planning

• Conduct comprehensive clinical and psychosocial assessments of patients virtually to identify individual health needs and goals.
• Develop, implement, and regularly update individualized, evidence-based care plans in collaboration with treating physicians.
• Coordinate multi-provider schedules, virtual specialist referrals, and transitions of care to ensure seamless patient journeys.
• Assist patients in navigating the healthcare system, explaining treatment paths, and scheduling follow-up virtual visits.

2. Utilization Review & Resource Management

• Review patient treatment tracks for medical necessity, ensuring alignment with evidence-based clinical criteria.
• Coordinate directly with insurance providers to obtain pre-authorizations and manage concurrent reviews for covered services.
• Identify and connect patients with community assistance programs, financial resources, and local support services to address social determinants of health (SDOH).

3. Patient Advocacy & Monitoring

• Conduct virtual check-ins to monitor patient adherence to medication, therapy schedules, and lifestyle modifications.
• Educate patients and their support networks on disease management, preventative care strategies, and telehealth platform usage.
• Track key clinical outcome metrics, documentation accuracy, and patient satisfaction indicators to report during internal quality reviews.

Requirements & Qualifications

Education & Credentials

• License Preferred: Active, Licensed Clinical Social Worker (LCSW) license in the State of Florida.
• Certification Preferred: Certified Case Manager (CCM) or Accredited Case Manager (ACM) designation is highly preferred.
• Degree: Bachelor’s degree in nursing (BSN), Social Work (MSW preferred), or a related health sciences field.

Experience & Skills

• Experience: Minimum of 3 years of clinical case management experience, preferably within and managed care organization, hospital system, or home health setting.
• Telehealth Literacy: Strong comfort level utilizing virtual care delivery platforms, remote patient monitoring tools, and modern Electronic Health Records (EHR).
• Communication: Empathetic, clear verbal and written communication skills optimized for phone and video interactions with diverse patient populations.
• Location Constraint: Must reside in Florida to fulfill hybrid office requirements and understand regional community health resources.

Compliance & Legal Disclosures

• Equal Opportunity Employer: PsynergyHealth is an Equal Opportunity Employer. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability.
• FLSA Status: This position is classified as Exempt under the Fair Labor Standards Act (FLSA). [29]
• Privacy & Healthcare Standards: The Case Manager must maintain absolute compliance with HIPAA and privacy rules, safeguarding sensitive Protected Health Information (PHI) across all digital and telephonic communications. [30, 31, 32]

Core Competencies

• Clinical Credibility: Ability to speak the language of doctors, nurses, and hospital administrators with high authority.
• Problem Solving: Skill in diagnosing complex systemic workflow bottlenecks and designing quick, elegant software workarounds.
• Communication: Exceptional verbal, written, and presentation skills suited for C-suite alignment.

Performance Expectations

Success in this role includes:

• High-quality, patient-centered virtual encounters
• Timely completion of documentation
• Meeting productivity benchmarks
• Active participation in team collaboration and continuous improvement efforts

Why Join Us?

• Be part of an innovative virtual care delivery model
• Flexible work-life balance
• Supportive and collaborative team culture
• Opportunity to shape and grow a cutting-edge Transitions of Care program
• Meaningful impact on patient outcomes during a critical period of care
• Competitive compensation (details provided during interview process)

Apply today and help us create a healthier future, one transition at a time.