Nurse Case Manager II

Job Description

Must Have:

IL resident who lives in one of the counties listed below and is interested in doing field case management with the elderly and individuals with disabilities who are approved for in-home or nursing facility care. We have 1 position total. On each resume, please clearly list which county/counties the candidate is applying for.

Candidate to cover: Bureau County

Position will require travel to members\' homes up to 50-75% travel. Must live near areas listed due to travel requirement and will work at home in between visits. We want someone who is organized, efficient, and can work independently.

RN, LCSW, or LCPC with current unrestricted state licensure in IL. REQUIRED

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 RN, LCSW, or LCPC with unrestricted active license. Experience with case management and IL waiver services is preferred.

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

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

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, LCSW, or LCPC with unrestricted active license.

Education

RN, LCSW, or LCPC with current unrestricted IL state licensure REQUIRED

What days & hours will the person work in this position List training hours, if different.

M-F 8-5 CST

Full-time

Fully remote