Insurance Case Manager Remote Jobs in Spring Valley, NY

Care Manager (Remote)
Hiring through Medix Staffing

Location: Fully Remote (U.S.-Based)

Schedule: Monday-Friday | 9:00 AM-5:30 PM EST

Pay: $21-$24/hour

Employment Type: Full-Time Contract (Long-Term / Indefinite Contract)

Start Date: July 20, 2026

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About the Opportunity

Medix is partnering with a rapidly growing healthcare organization that supports Medicaid members throughout New York State by addressing health-related social needs (HRSNs) and improving access to essential community resources.

This role is ideal for candidates with Care Management, Case Management, Health Home, Community Health, Social Services, or Medicaid Managed Care experience who are passionate about helping underserved populations navigate barriers to care and improve overall health outcomes.

As a Care Manager, you will engage members telephonically, assess social needs, coordinate referrals, develop care plans, and ensure services are successfully delivered through a closed-loop care model. You will serve as a key resource for members by connecting them to services that address social determinants of health (SDOH), including food insecurity, housing instability, transportation barriers, utility assistance, healthcare access, and other essential community supports.

This is a fast-paced, outreach-driven role that requires strong communication skills, exceptional organization, critical thinking, adaptability, and a genuine passion for helping others.

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Key Responsibilities
Member Outreach & Needs Assessment

• Conduct outbound phone outreach to Medicaid members.
• Complete comprehensive assessments focused on health-related social needs and social determinants of health.
• Identify unmet needs related to housing, food access, transportation, healthcare access, utilities, and other community supports.
• Build trust and rapport with members and caregivers while gathering information about barriers to care and personal goals.
• Prioritize members based on acuity, risk factors, and identified needs.

Care Planning & Care Coordination

• Develop individualized care plans based on assessment findings.
• Coordinate services with healthcare providers, community-based organizations (CBOs), social service agencies, and community partners.
• Support members in navigating healthcare systems and community resources.
• Identify and address barriers preventing members from accessing recommended services.
• Ensure members understand available resources, next steps, and care plan goals.

Closed-Loop Referral Management

• Initiate, manage, and track referrals from start to completion.
• Monitor referral status and confirm services have been successfully received.
• Follow up with members, providers, and community partners regarding referral outcomes.
• Escalate unresolved referrals or service delays according to established workflows.
• Maintain accountability for referral completion and member engagement throughout the process.

Member Education & Engagement

• Educate members and caregivers on available healthcare and community resources.
• Utilize motivational interviewing techniques and culturally competent communication strategies.
• Encourage engagement, self-advocacy, and participation in recommended programs and services.
• Maintain ongoing communication through phone, text, and digital outreach channels when appropriate.

Documentation & Data Management

• Accurately document all member interactions, assessments, referrals, care plans, and outcomes within care management systems.
• Maintain HIPAA compliance and confidentiality standards.
• Track outreach activity, referral completion rates, care gap closure, and engagement metrics.
• Ensure documentation is completed accurately and within required timelines.

Collaboration & Quality Improvement

• Collaborate closely with interdisciplinary teams, including care managers, social workers, nurses, providers, and community partners.
• Participate in team meetings, case reviews, and quality improvement initiatives.
• Identify opportunities to improve member engagement, referral workflows, and overall care coordination effectiveness.
• Support organizational efforts to improve health outcomes for Medicaid populations across New York State.

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Required Qualifications

• Minimum 1+ years of Care Management, Case Management, Care Coordination, Community Health Worker, Health Home, Social Services, Behavioral Health, or related experience.
• Experience working with Medicaid populations.
• Strong phone-based outreach and member engagement experience.
• Excellent communication, active listening, and relationship-building skills.
• Strong organizational skills with the ability to manage multiple priorities simultaneously.
• Comfortable working in a fast-paced environment with evolving workflows and processes.
• Strong computer proficiency and ability to learn new technology platforms quickly.
• Ability to work independently while maintaining productivity and quality standards.

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Preferred Qualifications

• Health Home Care Management experience strongly preferred.
• Experience addressing Social Determinants of Health (SDOH) or Health-Related Social Needs (HRSNs).
• Community-Based Organization (CBO) experience.
• Medicaid Managed Care experience.
• Behavioral Health experience.
• Community Resource Navigation experience.
• Motivational Interviewing experience.
• Bilingual language skills (Spanish or any additional language) highly preferred.
• Experience using electronic health records (EHRs), care management platforms, or CRM systems.

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Remote Work Requirements (Non-Negotiable)

Candidates must have:

• Reliable high-speed internet service.
• Active Ethernet connection prior to starting employment.
• Ability to provide proof of Ethernet connectivity during onboarding.
• Quiet, closed-door workspace free from distractions, background noise, children, television, or other interruptions during working hours.
• Ability to complete an internet speed test as part of the interview process.

Equipment Requirements

• Candidates must have access to a personal laptop.
• Candidates should be prepared to utilize their personal device during onboarding, training, and potentially for an extended period of time, including up to six months if necessary.
• Company equipment may be provided in the future based on business needs and program growth, but this is not guaranteed.
• Chromebooks and tablets are not permitted.
• Device must support Microsoft Teams, multiple browser windows, care management systems, and daily documentation activities.

Preferred:

• Multiple monitor setup.
• USB headset.
• Dedicated home office environment.

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What Success Looks Like

Successful Care Managers are:

• Patient, empathetic, and member-focused.
• Comfortable making consistent outbound calls throughout the day.
• Able to think critically and problem-solve in real time.
• Highly organized and detail-oriented.
• Strong multitaskers capable of managing multiple members, referrals, and priorities simultaneously.
• Adaptable and comfortable working within a growing program where processes and workflows may evolve.
• Passionate about improving outcomes for underserved populations.

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Why Join This Opportunity?

• Fully remote position.
• Meaningful work supporting Medicaid members and underserved communities.
• Direct impact on helping individuals access food, housing, transportation, healthcare, and other essential resources.
• Opportunity to work within an innovative closed-loop care model focused on whole-person health.
• Growing healthcare organization with expanding programs throughout New York State.
• Stable full-time schedule with long-term contract potential.

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Important Program Information

This program operates in partnership with Social Care Networks (SCNs) and Community-Based Organizations (CBOs) throughout New York State. As program requirements evolve, workflows, systems, and processes may change to align with state guidelines and partner expectations.

Candidates who thrive in this environment are flexible, adaptable, solutions-oriented, and comfortable navigating change while maintaining a high level of service and member support.

While this position is being offered as a long-term contract opportunity, there is no guarantee of permanent employment. However, successful contractors may be considered for future conversion opportunities based on business needs, program growth, attendance, and performance.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?