Nurse Case Manager II - Clinical

County locations: can live anywhere in IL

*** Put zip code at the top of their resume ***

Clinical Role
LCPC, LCSW or RN with current unrestricted state licensure in IL. REQUIRED
Hybrid position - field and remote

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.

Requires an LCSW or LCPC or RN with unrestricted IL active license. Experience with case management.

-Through 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/services
-Application 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 appropriate administration of benefits
-Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Position Summary:

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires unrestricted driver's license and car. Requires RN with unrestricted active license.

Duties:

Through 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/services.
Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate administration of benefits.
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Experience:

Minimum 3-5 years clinical practical experience preferred
Minimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferred
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

Education:

RN or LCPC or LCSW with current unrestricted state licensure.
Case Management Certification CCM preferred