Chronic Care Management

Company Overview
WC Health is dedicated to providing patients with comprehensive and integrated healthcare services, with a special focus on behavioral health. Our organization is committed to delivering accessible, patient-centered care across multiple convenient locations.

Job Summary
We are seeking a dedicated and detail-oriented Chronic Care Management specialist to enhance patient outcomes through proactive care coordination. The ideal candidate will possess a strong background in healthcare delivery, medical coding, and case management, with a focus on managing chronic conditions. This role involves coordinating care plans, ensuring compliance with healthcare regulations, and supporting patients in managing their health effectively.

Duties

• Coordinate and monitor ongoing care for patients with chronic conditions, ensuring adherence to personalized care plans.
• Utilize CPT coding, ICD-9, and ICD-10 coding systems accurately for documentation and billing purposes.
• Collaborate with healthcare providers, social workers, and behavioral health specialists to develop comprehensive discharge planning and follow-up strategies.
• Manage medical records meticulously, ensuring HIPAA compliance and confidentiality at all times.
• Conduct intake assessments to identify patient needs and facilitate appropriate case management interventions.
• Support discharge planning processes by coordinating post-acute care services and patient education.
• Maintain thorough documentation of patient interactions, medical terminology, and treatment progress within electronic health records.
• Engage in patient service activities that promote understanding of medical conditions and foster ongoing engagement in care.

Essential Functions:

• Complete individualized patient-centered care plans and provide management services using CCM software.
• Maintain frequent patient contact to coordinate care, provide support, and ensure program compliance to improve outcomes.
• Communicate emergent needs or life‑threatening episodes to Psychiatric Clinicians.
• Accurately document all verbal and written client communications in a timely manner.
• Manage a caseload of up to 500 members.
• Coordinate with schedulers to set and verify all required patient appointments.
• Manage referrals and review member medications as necessary.
• Qualify members for end-of-month billing and add them to the billing system.
• Create and update care plans and review member charts as needed.

Knowledge, Skills, and Abilities:

• Strong oral, written, and phone communication skills.
• Ability to work independently with excellent organization and time management.
• Knowledge of clinical practices, diagnostic procedures, and treatment protocols.
• Strong clinical judgment and critical thinking skills.
• Ability to build trusting relationships with patients and partner practices in a fast-paced environment.
• Results‑oriented with a focus on quality and daily productivity.
• Proven problem‑solving, consultative, and customer service skills.

Qualifications

• Proven experience working within hospital or acute care settings is highly preferred.
• Strong knowledge of medical coding practices including CPT, ICD-9, ICD-10, and medical terminology.
• Familiarity with social work principles, behavioral health integration, and pediatrics is advantageous.
• Experience in discharge planning, case management, and intake procedures is essential.
• Excellent organizational skills with attention to detail in managing medical records and documentation.
• Ability to communicate effectively with multidisciplinary teams while maintaining HIPAA compliance.
• Knowledge of hospital workflows, patient service protocols, and medical records management is desirable.
• A background in medical coding or healthcare administration will be considered an asset. Join our team to make a meaningful difference in the lives of patients managing complex health conditions through compassionate care coordination and clinical excellence!

Must be able to pass a drug and background check.