Case Manager/Care Coordinator

Case Manager/Care Coordinator

The Care Coordinator assesses, authorizes, and manages Community Care Program (CCP) services, providing ongoing case management to both CCP and Title III eligible participants across Whiteside, Carroll, Ogle, and Lee Counties. This position ensures timely eligibility, determination, service authorization, and compliance with Illinois Department on Aging (IDoA) regulations.

This position carries out case managing responsibilities in accordance with organizational policies and applicable laws.

Essential Duties and Responsibilities:

• Travel safely to client homes and other locations
• Accept and follow up on service inquiries.
• Conduct community-based assessments for eligibility, using intake forms, comprehensive needs assessments, and Determination of Need (DON).
• Develop Person-Centered Plans of Care (PoC) and Participant Agreements (PA) to authorize CCP services.
• Arrange service implementation with IDoA-approved vendors.
• Perform or approve Choices for Care screenings in hospitals, rehabilitation, long-term care facilities, and community settings.
• Conduct Healthcare & Family Services OBRA-1 (Level I ID Screen).
• Make appropriate referrals and respond to client/applicant requests.
• Maintain detailed case records, including documentation of follow-up, reassessment, and termination.
• Participate in appeals processes or other IDoA matters as directed.
• Follow billing policies and procedures, complete billing activities in a timely manner.
• Assist CCP providers in dispute resolution under supervisor guidance.
• Comply with Critical Event Reporting requirements (incident reports, service improvement plans, requests for change of status).
• Assist with Medicaid applications and redeterminations for participants and applicants.
• Comply with all IDoA and internal policy deadlines, performance measures, initiatives, and projects.
• Complete all required certification and training to maintain compliance with IDoA and agency policies.
• Participate in on-call rotation.
• Maintain teamwork and comradery, prioritizing client service.
• Serve in all Care Coordination Unit capacities as trained
• Assess and authorize CCP services; provide ongoing case management to CCP and Title III participants.
• Receive service requests from clients, family members, and community partner.
• Complete comprehensive assessments and redeterminations within required timelines.
• Conduct six-month face-to-face follow-ups.
• Maintain ongoing communication with supervisor while in the field.
• Complete Choices for Care duties as assigned.
• Attend assigned required trainings to remain current on applicable laws, regulations, and industry standards.
• Maintain timely and accurate required documentation of service given to clients.
• Participation in activities and events to promote agency services, may include giving presentations at various locations on benefits and services, is required.
• Attend required trainings as directed by the Supervisor, Director, CEO or CHRO to remain current on all internal policies, applicable laws, regulations, and industry standards.

Minimum Requirements:

The employee must meet the following requirements:

Must meet the Illinois Administrative Code Title 89 Section 220.605 requirements:

• RN, BSN, or BA/BS degree in social sciences, social work, or related field. One year of program experience (assessment, provision, or authorization of services for the elderly) may replace one year of college education, up to four years.
• LPN with one year of program experience (assessment and provision of services for the elderly and/or authorizing service provision).
• Ability to exercise independent judgment and function autonomously within established guidelines.
• Demonstrated strong decision-making abilities, attention to detail and effective communication skills, dependability, and openness to new ideas.
• Ability to balance and prioritize multiple responsibilities effectively.
• Valid IL driver's license, clean driving record, and own transportation with current insurance coverage.