Case Manager I
Reference Code: 5020
Position Title: Case Manager I, 16857-1
Location: IL 100% REMOTE (within Jo Daviess, Stephenson, Winnebago, Boone, Carroll, Ogle, Dekalb, Lee, Whiteside, Rock Island, Henry, Bureau, Putnam, LaSalle, Marshall, Stark, Woodford, Peoria, Tazewell, Knox, Fulton, Warren, Mercer, and Henderson counties)
Duration: 6 months with possible extension
100% remote- Candidate needs to live within the following counties within the team’s region, Region 1: Jo Daviess, Stephenson, Winnebago, Boone, Carroll, Ogle, Dekalb, Lee, Whiteside, Rock Island, Henry, Bureau, Putnam, LaSalle, Marshall, Stark, Woodford, Peoria, Tazewell, Knox, Fulton, Warren, Mercer, and Henderson
***** Please indicate which county on the resume/summary.***
Work hours: During training it is 8-4:30 with a half hour lunch and usually stays on the same schedule unless discussed otherwise
works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
• Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for members.
• May implement specific wellness programs i.e. asthma and depression disease management.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• Uses motivational interviewing and clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with RN case managers/supervisors as needed or required
• Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
• Local travel of up to 40% may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Central Programs unit.