Job DescriptionJob DescriptionDescription:
Case Manager
Department: Administration
Reports To: Clinic Operations Director
FLSA Classification: Exempt
Last Updated: Feb 2025
About Primary Health Solutions
Our Mission
We meet people where they are and partner with them on their journey towards wellness.
Our Vision
The destination for servant leaders to provide comprehensive and exceptional care.
Our Values
R – Respect
I – Innovation
S – Stewardship
E – Excellence
Case Manager Summary
The Case Manager will facilitate the transition of individuals from jail to the community, focusing on
connecting them to primary care and addressing healthcare needs. They will coordinate care, assist
with navigating the healthcare system, and address social determinants affecting reintegration. This
role ensures access to medical, medication, behavioral health, and social services post-incarceration.
Additionally, the Case Manager embodies PHS’ RISE values in interactions with patients and staff.
A Day in the Life
This job description reflects management's assignment of essential functions. Nothing in this job
description restricts management’s right to assign or reassign duties and responsibilities to this job
at any time.
Facilitate care coordination for patients transitioning from jail or other community institutions, ensuring they are linked to primary care services immediately upon release.Complete intake assessments for individuals leaving jail to identify their medical, mental health, and social needs.Develop and implement individualized care plans in collaboration with PHS care team and community partners.Schedule and coordinate appointments for patients needing medical care, mental health services and other specialty care.Monitor patient progress and provide regular follow-up to ensure adherence to care plans, medications and treatment recommendations.Provide benefit coordination including assistance in enrolling into state and federal benefits e.g., MedicaidConnect patients to community resources such as housing, transportation, food assistance, substance use treatment and other wrap-around services.Maintain accurate documentation of all interactions, care plans, and patient progress in the patient tracking system.Work with correctional facilities, probation officers, and other community organizations to ensure seamless service coordination and care delivery.
Core Competencies
Making Complex Decisions: decision qualityTaking Initiative: action-orientedInfluencing People: communicates effectively, drives engagementBeing Authentic: instills trustBeing Open: demonstrates self-awareness, self-developmentBeing Flexible and Adaptable: being resilient and nimble learner Requirements:
Success Requirements
To perform this job successfully, an individual must be able to perform each essential duty
satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability
required. Reasonable accommodation may be made to enable individuals with disabilities to perform
the essential functions.
Education/Experience
Bachelor’s degree in social work, Nursing, Psychology, or a related field is required. A minimum of 2
years of case management experience is required, preferably in a healthcare or social services setting.
Experience working with individuals transitioning from the criminal justice system (e.g., jail or prison)
is strongly preferred. Knowledge of benefit coordination, community resources, and behavioral
health care services is preferred.
Language Skills
Ability to communicate effectively with individuals from diverse backgrounds, including those with
varying literacy levels and cognitive abilities. Proficiency in written and verbal communication,
including the ability to write clear, concise case notes and progress reports.
Reasoning Ability
Ability to solve practical problems and deal with a variety of concrete variables in situations where
only limited standardization exists. Ability to analyze complex situations, assess patient needs, and
devise effective care plans. Strong problem-solving skills, with the ability to work independently and
make decisions to meet patients' needs in a timely manner. Ability to adapt to changing
environments and effectively handle emotional or crisis situations with patients.
Computer Skills
To perform this job successfully, an individual should have the ability to gain knowledge to be
proficient of current electronic health record, practice management system and Microsoft 365
including Outlook, Excel and Word.
Other Applicable Requirements
Strong communicator and listener to patients and associates. Strong interpersonal skills (friendly,
caring, patient). Strong verbal/written communication skills. Strong organizational skills and attention
to detail.
Physical Demands
The physical demands described here are representative of those that must be met by an employee
to successfully perform the essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to stand, walk, use hands
to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally
required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to
25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral
vision, depth perception and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee
encounters while performing the essential functions of this job. Reasonable accommodations may
be made to enable individuals with disabilities to perform the essential functions. While performing
the duties of this Job, the employee is occasionally exposed to fumes or airborne particles; toxic or
caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate.
Affirmative Action/EEO Statement
It is the policy of Primary Health Solutions to provide equal employment opportunities without
regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual
orientation, genetic information or any other protected characteristic under applicable law.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of
activities, duties or responsibilities required of the employee for this job. Duties, responsibilities, and
activities may change at any time with or without notice
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