Care Management Specialist II

$38 per hour

EPITEC

Location: Downers Grove, Illinois
Type: Contract
Job #103791

Position: Care Management Specialist

Location: Downers Grove, IL (Remote, training is on-site and travel is required to homes/facilities)

Employment Type: Full-Time Contract

Pay: $38 per hour

Description: This position is responsible for discharge care coordination, episodic case management and pre-admission/post-discharge counseling for acute conditions. This position is responsible for handling duties in an independent manner and may assist other staff.

Responsibilities:

Coordinate discharge planning, transitions of care, and episodic case management, including pre- and post-discharge support
Collaborate with physicians, providers, and care teams to assess needs, develop care plans, and ensure appropriate patient outcomes
Educate members on treatment plans, medications, and post-operative care to reduce readmissions and ER utilization
Conduct outreach and engagement based on risk assessments, addressing barriers to care and supporting follow-up compliance
Coordinate services and referrals to community resources, transportation, home health, and specialty providers
Reconcile medications and monitor adherence to ensure patient safety and regulatory compliance
Assist members in navigating the healthcare system, including provider selection and appointment scheduling
Monitor cases for quality issues and escalate to QA/QI as needed
Support care coordination through documentation, communication, and participation in transition of care programs
Ensure compliance with HIPAA, regulatory standards, and organizational policies while maintaining confidentiality

Requirements:

Licensed Clinical Professional Counselor (LCPC) or Licensed Clinical Social Worker (LCSW) with current, active, unrestricted license in the state of Illinois
2 years of clinical experience and 1 year of health insurance/managed care experience
Knowledge of medical management policies and procedures
PC and database experience
Verbal and written communication skills
Customer service skills and interpersonal skills to discuss pre/post admission care with physicians, hospital staff and members
Ability and willingness to occasionally travel within assigned location
Possess transportation and current, valid driver's license for applicable state.

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Vacancy posted 13 hours ago

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