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Case Manager Jobs in Puerto Rico (NOW HIRING)

OncoHealth

Case Review Representative

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 ...

BDO USA

Manager, Program Management

San Juan, PR · On-site

May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...

BDO

Manager, Program Management

San Juan, PR · On-site

May oversee case management and other production staff Qualifications, Knowledge, Skills, and Abilities: Education: * Bachelor's degree, required; focus in public administration, planning, business ...

UHS

PR · On-site

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 ...

UHS

PR · On-site

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 ...

Alivia Health

Patient Service Manager

Guaynabo, 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 ...

Alivia Health

Patient Service Manager

Guaynabo, 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 ...

Centers Home

RN Clinical Manager

San Juan, PR · On-site

Clinical Manager Responsible for assuring the delivery of quality health care services to the ... case conferencing? * Maintains effective communication with staff and patients * Serves as a ...

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Case Manager information

What is a case manager?

Case managers are professionals who coordinate and manage support services for individuals in need, such as patients, clients, or social service recipients. They assess clients’ needs, develop care plans, and connect them with appropriate resources to improve their well-being. Case managers often work in healthcare, social services, or mental health settings and act as advocates to ensure clients receive comprehensive and effective support. Their goal is to help clients achieve the best possible outcomes through continuous monitoring and adjustment of care plans.

What do case managers do?

A case manager is a patient care professional who assesses and oversees a patient’s or client’s complete case. Case managers coordinate the many providers involved in a patient’s or client’s care. Depending on the particular position, this may mean coordinating social services, rehabilitation and therapy services, home healthcare, in-patient care, and more. Above all, case managers see that the needs of their patients' or clients' are understood clearly and met as best they can be.

What are the key skills and qualifications needed to thrive as a case manager, and why are they important?

To thrive as a Case Manager, you need strong organizational skills, a background in social work or a related field, and typically a bachelor's degree or relevant certification such as CCM (Certified Case Manager). Familiarity with case management software, electronic health records, and documentation systems is essential for managing client information efficiently. Outstanding communication, problem-solving, and empathy are vital soft skills for building trust and advocating for clients' needs. These competencies are crucial to coordinating resources, ensuring client well-being, and achieving successful outcomes in complex cases.

How does a case manager typically collaborate with other professionals to support clients?

Case Managers frequently work as part of a multidisciplinary team that may include social workers, healthcare providers, mental health professionals, and community resource coordinators. Regular communication and coordination are essential, as Case Managers often organize case conferences, share client progress updates, and advocate for client needs across various services. Collaborating effectively ensures that clients receive comprehensive and cohesive support, making teamwork and strong interpersonal skills critical for success in this role.

What is the difference between Case Manager vs Social Worker?

AspectCase ManagerSocial Worker
Required CredentialsCertification (e.g., CCM), relevant degreesDegree in social work (BSW, MSW), licensure
Work EnvironmentHealthcare facilities, community agencies, insurance companiesHospitals, schools, social service agencies
Employer & IndustryHealthcare, insurance, social servicesPublic and private social service organizations
Common Search/ComparisonFocus on care coordination and resource managementFocus on counseling, advocacy, and social support

While both roles involve supporting individuals in need, Case Managers primarily coordinate care and resources within healthcare and social service settings, often requiring certification. Social Workers provide counseling, advocacy, and emotional support, typically holding social work degrees and licensure. Understanding these differences helps in choosing the right career path or job search focus.

Is a case manager a hard job?

A case manager's job can be challenging as it involves managing complex client needs, coordinating services, and handling emotional situations. The role requires strong communication, organization, and problem-solving skills, and may involve working under pressure or with difficult cases.
More about Case Manager jobs

What are the most commonly searched types of Case jobs in Puerto Rico?

The most popular types of Case jobs in Puerto Rico are:

What job categories do people searching Case Manager jobs in Puerto Rico look for?

The top searched job categories for Case Manager jobs in Puerto Rico are:

What cities in Puerto Rico are hiring for Case Manager jobs?

Cities in Puerto Rico with the most Case Manager job openings:

Case Manager jobs near you
Infographic showing various Case Manager job openings in Puerto Rico as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Case Review Representative

OncoHealth

Guaynabo, PR • On-site

Full-time

Re-posted 25 days ago

Job description

About OncoHealth
OncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the physical, mental, and financial complexities of cancer through technology enabled services. Supporting more than 14 million people in the US and Puerto Rico, OncoHealth offers digital solutions for treatment review and virtual care across all cancer types.
About the Role
The Case Review Representative serves as a one-stop shop and intake of all calls (members and providers). Resolves tier one issues (user resets, provider data management, fax and letter receipt, general questions).
Primary Responsibilities
  • Flexible to work rotational shifts inside our office hours from 8:00 a.m. - 8:00 p.m. EST to cover the operational needs of the company. Shifts can range anywhere between Monday - Friday 8:00 am to 8:00 pm EST and Saturdays 8:30 am - 5:00 pm EST (Office hours may change/extend upon operational needs)
  • Fax intake and labeling
  • Prior authorization creation
  • Quality Performance Program Outreach when assigned
  • 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 specific emails to an appropriate team member, and resolving tier 1 level issues
  • Triage request/claims processing issues to health plans as needed Prior authorization creation
  • Quality Performance Program Outreach when assigned

About You
  • College degree or relevant experience preferred
  • Fully Bilingual (English and Spanish)
  • Remote/hybrid work experience preferred
  • A minimum of 2 years of healthcare related administrative experience and/or customer service or relevant educational attainment required
  • Skills for implementation of systems for program effectiveness and productivity required
  • Systems/Tools: MS Office Suite proficient

About the Location
OncoHealth is committed to remote, hybrid or in office work options. Our Team in Puerto Rico reports to the office at least 2 times per month (advance notice provided/mandatory requirement) and can work remotely from home the rest of the days. Employees are welcome to work from the office every day if wanted.
Our Culture
Taking ownership of quick action, critically thinking through the needs, and working well with others are key competencies of team member success. Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation - all with a focused mission of putting patients first!
We offer a full benefit package on your first day, along with a company bonus. You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter. We enjoy being together!
OncoHealth is committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and team members without regard to race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. All employment decisions are based on qualifications, merit, and business need.
The Opportunity
The cost of cancer related medical services and prescription drugs in the United States is expected to reach $246 billion by 2030. OncoHealth has enjoyed rapid growth over the past 3 years and seeks smart, collaborative people to join its team. We have just under 250 team members, so we can move swiftly but precisely to the market needs of our customers. Strongly backed financially by Arsenal Capital Partners & McKesson Corporation, we remain in an investment and growth mode. This means we are open-minded to how we get the work done - now is the perfect time to talk to us!
Our Current Solutions
Through the use of OncoHealth's utilization management system, OneUM, our customers can use a single e-Prior Authorization portal for all oncology drug request and treatments. Our system improves quality of care, reduces provider abrasion and gives health plans visibility into the total cost of oncology treatment.
OncoHealth offers Oncology Insights Pro, an analytic software solution that enables health plans to use data and analytics to improve oncology programs. Using real world data, our engineers normalize data to create analytic dashboards with drill down compatibilities. The data is the paired with expert guidance providing the strategies an insight needed to keep up with the continuing evolving cancer treatment landscape.
OncoHealth offers Pharmacy Consulting services to health plans and pharmaceutical companies. New cancer treatments are entering the market at an unrelenting pace. Since 2018, the FDA approved 121 new cancer applications including 49 novel cancer drug entities. Our Board-Certified Oncology Pharmacologists can help health plans update drug policies, offer utilization management and formulary advice, and development training for staff.
OncoHealth's latest offering is Iris, a digital telehealth platform that delivers personalized, oncology-specific support to navigate the physical symptoms and emotional challenges caused by cancer and cancer treatment. Powered by technology, staffed 24X7, and delivered with empathy, Iris allows patients to connect with trained oncology experts and receive personalized, oncology-specific telehealth support.

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