Position Summary:The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.DutiesThrough the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/servicesApplication and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriateadministration of benefitsUtilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and proceduresExperienceMinimum 3-5 years clinical practical experience preferredMinimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferredConfidence working at home/independent thinker, using tools to collaborate and connect with teams virtuallyExcellent analytical and problem-solving skillsEffective communications, organizational, and interpersonal skills.Ability to work independentlyEffective computer skills including navigating multiple systems and keyboardingDemonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applicationsRequires unrestricted driver's license and car.Requires RN with unrestricted active license.Requires an RN with unrestricted active licenseEducationRequires an LCSW or LCPC or RN with unrestricted IL active license.Experience with case management.Case Management Certification CCM preferredNotes:8am to 5pm CST Mon-Fri
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