Case Manager

Job Title: Care Management / Care Coordination Specialist Job Location: IL (Remote+ Field visits in your local area). Schedule: Monday–Friday, 8:00 AM–5:00 PM Required Experience: 2+ years Job Summary: The Care Management/Care Coordination Specialist provides support for long-term services and supports (LTSS) and collaborates with multidisciplinary teams to coordinate integrated care for members with complex or high-need conditions. The role focuses on helping members achieve desired outcomes while supporting quality, cost-effective care across the continuum. Key Responsibilities: Complete comprehensive member assessments within required regulatory timelines, including in-person home visits when required. Facilitate waiver enrollment and disenrollment processes. Develop and implement individualized care plans and waiver service plans in collaboration with members, caregivers, physicians, healthcare professionals, and support networks. Monitor care plans, evaluate effectiveness, document interventions and progress, and recommend changes as needed. Coordinate behavioral health, LTSS, home, and community-based services to promote continuity of care. Assess medical necessity and authorize appropriate waiver services. Evaluate covered benefits and provide guidance regarding available funding sources. Facilitate interdisciplinary care team (ICT) meetings for service approvals or denials and support informal ICT collaboration. Use motivational interviewing and clinical guideposts to educate, support, and motivate members. Identify barriers to care and coordinate resources to address psychosocial, financial, and medical needs. Identify critical incidents and develop prevention plans to support member health and safety. Collaborate with licensed care managers and leadership as needed. Travel locally approximately 25–40% of the time, based on state and contractual requirements. Required Qualifications: Minimum of 2 years of healthcare experience , including: At least 1 year of experience working with individuals with disabilities, chronic conditions, or long-term services and supports (LTSS), and At least 1 year of experience in care management; or experience in a medical and/or behavioral health setting; or an equivalent combination of education and experience. Valid and unrestricted driver's license. Reliable transportation and adequate auto insurance for work-related travel, unless otherwise required by law. Knowledge of community resources and support services. Ability to work effectively with diverse populations and adapt to different settings and situations. Strong attention to detail, initiative, and ability to work independently with minimal supervision. Ability to remain calm and responsive in high-pressure situations. Strong relationship-building and communication skills. Excellent time-management, prioritization, problem-solving, and critical-thinking skills. Ability to manage multiple priorities and adapt to changing needs. Proficiency with Microsoft Office and the ability to navigate online portals and databases. #J-18808-Ljbffr Integrated Resources, Inc ( IRI )