Case Manager I Jobs in Hybrid OH \ Healthcare / Medical Job Recruiters

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Posted: 01/29/2026 Industry: Healthcare / Medical Job Number: 26-13115 Pay Rate: 39.28-41.28 USD/Hour

Job Description

Job Tittle: Healthcare - Case Manager I
Location: Hybrid
Shift Timing: Mon - Fri 8-5
Duration: 3+ Months
Pay Range: $39.28 - $41.28

Job Description:

Work is remote, however, home visits to members are required. Visits will be in greater Cincinnati area so candidates MUST be local to Cincinnati, OH or nearby
RN, LSW, or LISW licensure is required.
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 Client member’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.
Performs ongoing monitoring of the plan of care to evaluate effectiveness.
Documents care plan progress in Client information system.
Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes.
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.
Attends regular staff meetings.
Responsibilities
Participates in Interdisciplinary Care Team (ICT) meetings
Assists with orientation and mentoring of new team members, as appropriate
Maintains professional relationships with the 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 the company Code of Conduct
Participates in appropriate case management conferences to enhance skills 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 skills with the ability to manage multiple priorities
Ability to work independently and handle multiple projects simultaneously
Strong analytical skills
Knowledge of applicable state and federal regulations
Knowledge of ICD-9, CPT coding, and HCPCS
Knowledge of 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 through to completion
Computer skills with experience using Microsoft Office products
Excellent verbal and written communication skills
Ability to abide by Client policies
Ability to maintain regular attendance based on the agreed schedule
Maintains confidentiality and complies with HIPAA requirements
Skilled in establishing and maintaining positive working relationships with coworkers, clients, members, providers, and customers

Required Education

Bachelor’s degree in Nursing, or
Master’s degree in Social Work or Health Education
A combination of education and experience may be considered in lieu of a degree

Required Experience

0–2 years of clinical experience
Case management experience
Required Licensure / Certification
Active, unrestricted State Registered Nursing license, or
Licensed Clinical Social Worker (LCSW), or
Advanced Practice Social Worker (APSW) in good standing
A combination of education and experience may be considered in lieu of LCSW or APSW
Valid driver’s license with a good driving record and ability to drive locally