Case Manager

Job Description

Job DescriptionSummary
Under the direct supervision of a Senior Case Manager, the Case Manager provides services to individuals with epilepsy and their families, maintaining accurate and up-to-date records and fulfilling all requirements as stipulated within the Florida Department of Health contract.
Key responsibilities include managing clients through all stages of care—screening, assessing, planning, implementing care coordination (in partnership with subcontracted facilities and physicians), follow-up, transitional care, and evaluation.
This role requires current knowledge of best practices, treatments, and medical terminology related to epilepsy and seizures. A strong emphasis is placed on epilepsy education for clients, consumers, and the community. Independent judgment is necessary for planning, prioritizing, and organizing a diverse workload and recommending changes to virtual office practices or procedures.

Essential Duties and Responsibilities
Case Management – 70%

• Complete Application Forms for new or reopened clients.
• Complete ACMR forms.
• Develop individualized Plans of Care after assessing client needs (addressing neurological, epilepsy education, psychological, financial, and employment issues).
• Maintain accurate, up-to-date documentation for each client.
• Assist clients with advocacy needs.
• Refer clients to appropriate medical, psychological, employment, and other support services.
• Provide services to at least 40% of caseload monthly.
• Prepare monthly ACMR and final letters for clients due for review. Print on letterhead, sign, make copies, and input into client files and CCM.
• Mail all letters to clients.
• Retrieve lab results from Quest, fax results to neurologists, input into CCM, and record in client files.
• Process invoices for payment; stamp, initial claim forms, and submit for processing.
• Review medical records received for clients.
• Complete and fax authorizations to neurologists/clinics for initial consultations, follow-ups, EEGs, MRIs, CT scans, and lab work.
• For new clients, contact billing department to have case built before scheduling initial consults and fax over release of information forms.
• Provide Patient Assistance Program support as needed.
• Provide emergency medications to clients as needed and as budget allows.
• Maintain and update waiting lists for new clients as needed.

Screening and Intake – 20%

• Complete screening and intake processes within required timeframes.

Caseload Management – 10%

• Maintain a balanced caseload, in compliance with contractual requirements.

Additional Duties and Responsibilities

• Professionally engage and collaborate with EF national office staff as needed.
• Take information and referral calls on designated on-call days.
• Lead monthly support groups, including recruitment, promotion, and facilitation.
• Coordinate with guest speakers and experts for specialized support group sessions.
• Maintain records and reports of support group attendees.
• Coordinate or complete special projects as required.
• Provide virtual and in-person support at EF events and activities within the designated geographic territory as directed.
• Maintain accurate and complete constituent records.
• Perform other duties and special projects as assigned.

Education Requirements

• Associate degree required; Bachelor’s degree preferred.

Experience Requirements

• Minimum of three (3) years of related work experience.
• Proficiency in Microsoft Office and other database software platforms; ability to learn new technical systems as needed.
• Experience with Adobe Professional and graphics programs preferred.

Essential Skills

• Bilingual strongly preferred; at a minimum, ability to communicate effectively with Spanish-speaking individuals.
• High attention to detail and accuracy.
• Ability to prioritize tasks, manage multiple projects simultaneously, and follow through to completion.
• Ability to work independently with minimal supervision, demonstrating ownership and urgency in completing tasks.
• Strong time management and problem-solving skills.
• Excellent written, verbal, and interpersonal communication skills.
• Sound judgment and ability to maintain strict confidentiality.
• High level of professionalism, with the ability to interact effectively with clients from diverse backgrounds.

Supervisory Responsibilities

• This position has no supervisory responsibilities.

Manages

• Number of Direct Reports: 0

Travel, Work Environment, and Physical Demands

• Full-time position, 35 hours per week.
• Hybrid work environment, requiring three days in-office and two days remote each week.
• Operates in a professional office environment and routinely uses office equipment.
• Duties may include prolonged periods of computer work, standing, filing, lifting boxes, and arranging meeting spaces.
• Minimal travel expected, but may occasionally be required for events or essential office visits.
• Some evening and weekend work may be necessary for events or programs.
• Telework privileges are available in accordance with the organization’s telework policy, contingent upon satisfactory performance and customer service.

Pay Range

• $19.23 - $24.03

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