PR · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Certification as a Case Manager or a BS in a health or human services related field also preferred. For URAC accredited areas, the following applies: Current and active RN license required in ...
PR · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Certification as a Case Manager or a BS in a health or human services related field also preferred. For URAC accredited areas, the following applies: Current and active RN license required in ...
Guaynabo, PR · On-site
Triage and manage inbound calls, routing case specific calls to an appropriate team member, and resolving tier 1 level issues * Triage and manage inbound emails from health plan clients, routing case ...
Guaynabo, PR · On-site
Triage and manage inbound calls, routing case specific calls to an appropriate team member, and resolving tier 1 level issues * Triage and manage inbound emails from health plan clients, routing case ...
PR · On-site
$14.25 - $17.50/hr
En general, el (la) manejador(a) de casos de Key Accounts será responsable de las siguientes tareas: i. Revisar e interpretar las recetas médicas para garantizar las terapias apropiadas. ii. ...
Quick apply
PR · On-site
$14.25 - $17.50/hr
En general, el (la) manejador(a) de casos de Key Accounts será responsable de las siguientes tareas: i. Revisar e interpretar las recetas médicas para garantizar las terapias apropiadas. ii. ...
San Juan, PR · On-site
$22.50/hr
Provide case management for children and, occasionally, adolescents, ensuring timely interventions and follow-up. * Conduct school visits and maintain regular presence within assigned schools.
Quick apply
San Juan, PR · On-site
$22.50/hr
Provide case management for children and, occasionally, adolescents, ensuring timely interventions and follow-up. * Conduct school visits and maintain regular presence within assigned schools.
Arecibo, PR · On-site
$22.50/hr
Provide case management for children and, occasionally, adolescents, ensuring timely interventions and follow-up. * Conduct school visits and maintain regular presence within assigned schools.
Quick apply
Arecibo, PR · On-site
$22.50/hr
Provide case management for children and, occasionally, adolescents, ensuring timely interventions and follow-up. * Conduct school visits and maintain regular presence within assigned schools.
San Juan, PR · On-site
$60K - $80K/yr
Medical
Retirement
PTO
Collaborate closely with case managers, investigators, and medical professionals to strengthen claims. * Draft demand letters, review medical records, and prepare case files for potential litigation.
Quick apply
San Juan, PR · On-site
$60K - $80K/yr
Medical
Retirement
PTO
Collaborate closely with case managers, investigators, and medical professionals to strengthen claims. * Draft demand letters, review medical records, and prepare case files for potential litigation.
Position SummaryThe Social Worker provides direct case management services to participants. The primary role of the MSW is to assist participants and their family/caregivers to cope with the social ...
Quick apply
Position SummaryThe Social Worker provides direct case management services to participants. The primary role of the MSW is to assist participants and their family/caregivers to cope with the social ...
You will receive work through various channels, including phone calls (warm transfers from the Mobile Care Team), web, chat, email, the Case Management Console, etc. Task assignments may vary based ...
You will receive work through various channels, including phone calls (warm transfers from the Mobile Care Team), web, chat, email, the Case Management Console, etc. Task assignments may vary based ...
San Juan, PR · On-site
Retirement
May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...
San Juan, PR · On-site
Retirement
May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...
San Juan, PR · On-site
Retirement
May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...
San Juan, PR · On-site
Retirement
May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...
PR · On-site
Knowledge of patient services, call center, registry, referral intake, case management, or specialty pharmacy operations preferred. * Knowledge of operational performance management, service levels ...
New
Quick apply
PR · On-site
Knowledge of patient services, call center, registry, referral intake, case management, or specialty pharmacy operations preferred. * Knowledge of operational performance management, service levels ...
New
PR · On-site
Medical
Dental
Vision
Retirement
PTO
Offers support to Case Managers and to all the efforts related to complying with handling the phone calls. The Clinical Manager is responsible for telephonic counseling, managing referrals and ...
PR · On-site
Knowledge of patient services, call center, registry, referral intake, case management, or specialty pharmacy operations preferred. * Knowledge of operational performance management, service levels ...
New
Quick apply
PR · On-site
Knowledge of patient services, call center, registry, referral intake, case management, or specialty pharmacy operations preferred. * Knowledge of operational performance management, service levels ...
New
PR · On-site
Medical
Dental
Vision
Retirement
PTO
Offers support to Case Managers and to all the efforts related to complying with handling the phone calls. The Clinical Manager is responsible for telephonic counseling, managing referrals and ...
Medical
Dental
Vision
Retirement
PTO
This role blends clinical care, patient education, and case management. Key Responsibilities: * Train patients and caregivers on PD procedures and self-care * Manage a caseload of PD patients ...
Medical
Dental
Vision
Retirement
PTO
This role blends clinical care, patient education, and case management. Key Responsibilities: * Train patients and caregivers on PD procedures and self-care * Manage a caseload of PD patients ...
PR · On-site
Coordinate with Pharmacy, Case Management, Inventory, Logistics, and other operational teams to support timely delivery execution and continuity of therapy for specialty pharmacy patients. * Identify ...
Quick apply
PR · On-site
Coordinate with Pharmacy, Case Management, Inventory, Logistics, and other operational teams to support timely delivery execution and continuity of therapy for specialty pharmacy patients. * Identify ...
Be Seen First
San Juan, PR · On-site
$50K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Case Managers, Sales Associates, Tax Preparers, and fellow Practitioners to achieve best possible resolution * Excellent Opportunity for Newly Licensed Attorney! Significant post Law School ...
Quick apply
Be Seen First
San Juan, PR · On-site
$50K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Case Managers, Sales Associates, Tax Preparers, and fellow Practitioners to achieve best possible resolution * Excellent Opportunity for Newly Licensed Attorney! Significant post Law School ...
Medical
Dental
Vision
Retirement
PTO
This role blends clinical care, patient education, and case management. Key Responsibilities: * Train patients and caregivers on PD procedures and self-care * Manage a caseload of PD patients ...
Medical
Dental
Vision
Retirement
PTO
This role blends clinical care, patient education, and case management. Key Responsibilities: * Train patients and caregivers on PD procedures and self-care * Manage a caseload of PD patients ...
Guaynabo, PR · On-site
Retirement
PTO
Manage a team of construction oversight staff to perform periodic visits to monitor construction ... All accommodation requests are reviewed case-by-case in compliance with applicable law
Guaynabo, PR · On-site
Retirement
PTO
Manage a team of construction oversight staff to perform periodic visits to monitor construction ... All accommodation requests are reviewed case-by-case in compliance with applicable law
Retirement
PTO
Manage a team of construction oversight staff to perform periodic visits to monitor construction ... All accommodation requests are reviewed case-by-case in compliance with applicable law
Retirement
PTO
Manage a team of construction oversight staff to perform periodic visits to monitor construction ... All accommodation requests are reviewed case-by-case in compliance with applicable law
| Aspect | Case Manager | Social Worker |
|---|---|---|
| Credentials | Certifications like CCM or CMC often preferred | Licensure (LCSW, LISW, LSW) typically required |
| Work Environment | Healthcare, insurance, community programs | Hospitals, mental health clinics, social service agencies |
| Employer & Industry | Healthcare providers, insurance companies, community organizations | Government agencies, hospitals, nonprofit organizations |
| Common Search & Comparison | Often compared for client advocacy and care coordination roles | Compared for counseling, therapy, and social support services |
While both roles focus on supporting clients, Case Managers primarily coordinate care and manage services, often in healthcare or insurance settings. Social Workers provide counseling, advocacy, and emotional support, typically requiring licensure. Understanding these differences helps job seekers find the right role based on credentials, work environment, and career goals.
The top searched job categories for Case Manager Case Manager jobs in Puerto Rico are:
Cities in Puerto Rico with the most Case Manager Case Manager job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 29 days ago
7.7
Based on 351 frontline employees who took The Breakroom Quiz
204th of 309 rated insurance
Location: This role enables associates to workvirtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.Alternate locations may be considered if candidatesresidewithin a commuting distance from an office.This position will be based in Puerto Rico.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Carelon Global Solutions (CGS), a fully owned subsidiary of Elevance Health, is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.
Our Puerto Rico location operates a bilingual Spanish and English call center, providing clear and precise answers to customer queries.
Schedule:This position will work rotating 8-hour shifts between 8:30 am - 8:30 pm (ET), Monday through Friday. Additional hours, including weekends or holidays, may be required based on operational needs.
The Nurse Care Manager I is responsible for collaborating with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs.
How You Will Make an Impact
Primary duties may include, but are not limited to:
Ensures medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care.
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Minimum Requirements:
Requires a HS diploma or equivalent and a minimum of 3 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
Current, active valid unrestricted RN license in applicable state(s) required.
Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Skills, Capabilities, and Experiences:
Fully Bilingual (English & Spanish), Must be able to write, read and speak both languages in a proficiency level preferred.
AS or BS in nursing is strongly preferred.
NCLEX Certification or current unrestricted RN license from one of the 50 states of the United States is highly preferred.
Home health/discharge planning experience preferred.
Certification as a Case Manager or a BS in a health or human services related field also preferred.
For URAC accredited areas, the following applies: Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager or a BS in a health or human services related field also preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
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Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Health care and social assistance
10,000+ Employees
Indianapolis, IN, US
2004
