Case Manager

Summary of Position  

The Case Manager ensures the well-being of members/patients and guides them through their healthcare journey. As part of a specialized team, including Case Coordinators, physicians and nurses, the Case Manager optimizes clinical quality and ensures high member satisfaction across various Teladoc service lines. They follow members and patients through all stages, including but not limited to  triage/intake to report delivery, including provider selection and case matching. Assignments may focus on Acute Care, Mental Health, or other areas based on expertise with the expectation that the case manager will be flexible and cross-trained in all applicable areas. This allows flexibility and professional growth.   

Essential Duties and Responsibilities 

• Serve as the initial clinical contact for members/patients. 

• Direct members/patients to appropriate Teladoc services based on their medical condition. 

• Collect comprehensive health histories and document relevant medical data. 

• Provide ongoing clinical support and navigate the healthcare system for members. 

• Communicate clearly with members about service progress, ensuring high customer service levels. 

• Collaborate closely with Case Coordinators and the clinical team to support case progression. 

• Use technology to ensure case coordination and information integrity. 

• Review complex medical issues and ensure the accuracy of clinical summaries/reports. 

• Provide clinical expertise to support members in understanding their diagnoses and treatment recommendations.  

• Meet service standards for case progression, quality, and member satisfaction. 

• Ensure compliance with privacy legislation  

• Help select appropriate specialists using Teladoc’s database. 

• Follow up directly with providers on overdue reports. 

• Support providers with case consultation and referral to appropriate resources.  

• Document casework clearly and timely for transparency across departments. 

• Maintain accurate provider information in the system. 

• Conduct quality reviews to ensure thorough documentation. 

• Escalate case-related questions/concerns to Operations Leaders and the Medical Director(s). 

• Review provider reports for clinical accuracy and follow up as needed. 

• Liaise between the clinical team and providers to address questions and concerns. 

• Ensure timely support for provider inquiries. 

• Support special projects and activities as needed. 

If applicable: 

• Maintain relevant provincial nursing licenses  

• Obtain other licenses as required (supported by Teladoc). 

Supervisory Responsibilities 

None 

Qualifications Expected for Position 

• 5+ years’ nursing or relevant therapeutic experience  

• Direct care experience and strong clinical knowledge base 

• Excellent written, verbal, and documentation skills 

• Strong organizational skills and the ability to multitask with ease 

• Strong interpersonal skills 

• Quality driven with a focus on flawless customer service delivery 

• Competent using office productivity software (Microsoft Excel, Word, Outlook, PowerPoint, Adobe Acrobat); EMR and SaaS applications to search for information and enter data an asset 

• Multiple provincial nursing licenses are an asset (where applicable for the specific role) 

• Strong communication skills including verbal and written channels; telephone, email, and chat 

• Able to work a flexible schedule with occasional evening requirements 

Required license or credentials needed:  

• Bachelor's or Master's degree in nursing or other equivalent degree with 5+ years’ experience 

• Minimum of 3 years of clinical experience in acute (ER or ICU), oncology care, non-acute care (medical and surgical), or Mental Health 

• Good standing with the provincial governing body