Case Manager

Case Manager - DC Medicaid

Job Overview:

As a Case Manager, you will provide care coordination and support for enrollees in the DC Medicaid program, many of whom face behavioral health challenges and socio-economic barriers. Your role will involve conducting assessments, developing care plans, and ensuring that members receive the appropriate level of support based on their needs.

Additional Details:

• Schedule: Monday-Friday, 8:00 AM - 5:00 PM, with flexible scheduling for field visits.

• Location: 3400 Martin Luther King Jr. Ave SE, Washington, DC.

• Salary: $75,000 - $80,000 + Children's National Benefits Package. (Some Flexibility with Salary)

• Dress Code: Business casual.

Typical Day-to-Day Responsibilities:

• Manage a caseload of Medicaid enrollees, assessing their needs and assigning an acuity level (1-3) to determine case management frequency and intensity.

  • Level 1: Well-managed cases requiring minimal Medicaid resources.

  • Level 2: Moderate resource utilization, requiring more frequent engagement.

  • Level 3: High-risk cases with greater healthcare needs, requiring frequent follow-up.

• Conduct needs assessments to determine enrollees' health and social service needs.

• Develop and maintain care plans to address medical, behavioral, and social challenges.

• Work closely with enrollees, families, and healthcare providers to break down barriers to care.

• Maintain a caseload of up to 100 enrollees, primarily ages 0-26, at Level 1 or Level 2 acuity.

• Perform at least three field visits per week to engage with members, with two in-office days for documentation and collaboration.

• Attend well-child visits when appropriate to provide additional support and update care plans.

• Build relationships with primary care providers to enhance coordinated care efforts.

Training & Onboarding:

• Three-week onboarding phase covering:

  • Company policies and procedures.

  • Medicaid contractual obligations and compliance.

  • Documentation and reporting requirements.

• Hybrid work model: Initial training will require more in-office time, with regular in-person meetings on Tuesdays for support and guidance.

Qualifications:

Must-Have:

• LGSW (Licensed Graduate Social Worker) certification.

• At least two years of experience in case management, social work, or healthcare.

• Background in pediatrics, health plans, or behavioral health.

Preferred:

• Five years of experience in case management or healthcare.

• Prior experience working with Medicaid members.

• Health plan or managed care experience.

Soft Skills & Attributes:

• Strong communication skills with the ability to connect with enrollees, families, and providers.

• Empathetic and patient-centered approach.

• Highly organized with the ability to manage multiple cases efficiently.

• Passion for serving underserved populations and improving healthcare access

Interview Process:

• Two-panel interview with Supervisor Case Managers (1 hour, virtual).