Nurse Case Manager II

Job Responsibilities:

• 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.
• Using 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

Skills:

• 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.

Education/Experience:

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