*Healthcare Consultant III - ICM Case Management Coordinator- Hybrid

Job Title: Healthcare Consultant III - Field Case Management Coordinator

Location : McLean, De Witt, Macon, Champaign, Douglas, Shelby and surrounding counties.

Duration: Could extend past 90 days



Shift Time: Mon-Fri 8am to 5pm CST

Pay Rate: $28.60/hr on W2 without benefits

Description :

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.

FIELD ROLE

Field Based Case Managers: Caseloads typically range from 30 to 100 members, depending on market needs and complexity of member's needs.

Mileage reimbursement:

Position will require travel to members' homes. 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.

Duties :

• Evaluation of Members : -
• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Enhancement of Medical Appropriateness and Quality of Care: -
• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Monitoring, Evaluation and Documentation of Care: -
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Experience :

• Case management experience preferred
• 2 years' experience in behavioral health, social services or appropriate related field equivalent to program focus
• Managed Care experience preferred

Position Summary:

The Field Case Management Coordinator 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. Experience with case management is preferred.

Education :

• Bachelor's degree in behavioral health or human services REQUIRED (psychology, social work, marriage and family therapy, nursing, counseling, etc.) or non-licensed masters-level clinician.