Case Management Analyst I

Additional Requirements:

• Must provide a screenshot of home WiFi speed test.
• Must have a dedicated private workspace with a door.

Job Summary:

• Analyst, Case Management (ACM) drive and support care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating).
• The ACM utilizes critical thinking and judgment to collaborate and inform the care management/care coordination process in order to facilitate appropriate healthcare outcomes for assigned members.
• They provide care coordination, support and education for members through the use of care management tools and resources.
• We are seeking an Analyst, Case Management (ACM) to support care coordination for members in a managed care environment.
• This is a remote, phonebased role with a caseload of 100–120 members (medium complexity).
• Candidates must reside in IL, IN, or WI and must have a private workspace with a door, a WiFi speed test screenshot, and be comfortable working in a remote setting.

Key Duties & Responsibilities:

• Conduct comprehensive assessments to determine member needs using care management tools.
• Identify high-risk factors, gaps in care, and barriers impacting member outcomes.
• Engage members using motivational interviewing and provide coaching to support lifestyle and behavior changes.
• Serve as the single point of contact for assigned members and help them navigate care decisions.
• Develop and monitor individualized care plans in collaboration with interdisciplinary care teams.
• Coordinate appointments, referrals, transportation, and social support services.
• Participate in case conferences and rounds.
• Collaborate with clinical care managers, medical directors, and behavioral health staff.
• Escalate crisis or clinical concerns appropriately.
• Maintain accurate, timely documentation in compliance with regulatory guidelines.
• Maintain electronic files and ensure compliance requirements are met.
• Identify and escalate quality-of-care issues.

Education:

• Bachelor’s degree in social work, psychology, or a related social services field.

Experience:

• 2+ years of experience as a Care Coordinator, Care Manager, or Behavioral Health professional.
• Managed Care Organization (MCO) experience required.
• Experience conducting member assessments and developing care plans.
• Experience working with diverse populations including physical, behavioral, and social health needs.
• Strong background in motivational interviewing, member engagement, and coaching.
• Experience coordinating services (medical, behavioral health, social services, transportation, community resources).
• Strong documentation and case note experience within compliance guidelines.
• Comfortable managing a medium caseload (100–120 members).
• Experience collaborating with interdisciplinary teams (nurses, medical directors, behavioral health staff).
• Remote work experience preferred; must be proficient in Microsoft Suite.

Preferred Experience:

• Case management in a health plan, Medicaid/Medicare, or community health setting.
• Experience supporting members with complex physical, behavioral, or social needs.
• Experience coordinating community resources and SDoH services.

Additional Qualifications:

• Must have a private athome workspace with a door and provide a WiFi speed test screenshot.
• Managed Care (MCO) experience required.
• Strong computer proficiency (Microsoft Office).
• Comfortable with remote work and structured productivity expectations.