Case Manager I

Integrated Resources Inc

Chicago, IL

Job Title: Case Manager I

Job Location: Chicago, IL

Duration: Full-Time

Shift Schedule: Day Shift

Summary:

Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with a multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to the overarching strategy to provide quality and cost-effective member care.

Responsibilities:

Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
Facilitates comprehensive waiver enrollment and disenrollment processes.
Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians, and/or other appropriate health care professionals and member support network to address the member needs and goals.
Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
Assesses for medical necessity and authorizes all appropriate waiver services.
Evaluates covered benefits and advises appropriately regarding funding sources.
Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
Uses motivational interviewing and Client clinical guideposts to educate, support, and motivate change during member contacts.
Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
Identifies critical incidents and develops prevention plans to assure member health and welfare.
Collaborates with licensed care managers/leadership as needed or required.
25-40% estimated local travel may be required (based upon state/contractual requirements).

Required Skills:

At least 2 years of health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance.
Demonstrated knowledge of community resources.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities, and personal situations.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work independently, with minimal supervision and self-motivation.
Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Problem-solving skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

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Vacancy posted 4 days ago

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