Care Manager RN

Care Manager RN

$41/hr (W2) Duration: 6 Months Location: Illinois (Must reside in IL) Work Type: Hybrid (90% telephonic)

Work Arrangement

• Hybrid role: primarily telephonic (approx. 90%)
• Member visits required only if requested and within 1 hour travel
• Quarterly office visit required Office Location: 3200 Highland Ave, Downers Grove, IL
• If candidate resides more than 2 hours away, quarterly meeting may be attended via Microsoft Teams
• Must have a quiet, private workspace at home to comply with HIPAA regulations

Position Summary

The Care Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care. This includes assessing, planning, implementing, coordinating, monitoring, and evaluating member care. The role utilizes advanced clinical judgment and critical thinking to support members' physical and behavioral health needs through care planning, provider collaboration, and coordination of psychosocial wrap-around services to achieve optimal, cost-effective outcomes.

Key Responsibilities

• Conduct telephonic and/or face-to-face assessments to ensure members' medical and behavioral health needs are met
• Develop proactive care plans addressing short- and long-term health goals
• Perform comprehensive assessments using clinical tools, data review, and member self-report
• Apply clinical judgment to reduce risk factors and address complex medical, behavioral, and social needs
• Analyze utilization, clinical, and self-reported data to identify comprehensive member needs
• Provide crisis intervention for members experiencing medical or behavioral health crises and refer appropriately
• Conduct crisis follow-ups to ensure continuity of care
• Serve as a single point of contact to close gaps in care and access
• Collaborate with interdisciplinary care teams, medical directors, and behavioral health professionals
• Present cases during case conferences or rounds for multidisciplinary input
• Utilize motivational interviewing to engage members and encourage active participation in care
• Educate and empower members to make informed healthcare and lifestyle decisions
• Develop, monitor, and update individualized care plans
• Facilitate clinical handoffs during transitions of care
• Identify and escalate quality of care issues through established channels
• Ensure compliance with regulatory, clinical, and company policies and guidelines

Required Qualifications

• Must reside in Illinois
• Active, unrestricted Illinois RN License
• Associate's Degree or Diploma in Nursing (required)
• 35 years of clinical practice experience (hospital, ambulatory, or outpatient setting)
• 2+ years experience using computers and navigating multiple systems/applications
• Proficiency with MS Office Suite (Teams, Outlook, Word, Excel)

Preferred Qualifications

• BSN
• Case management experience in an integrated care model
• Managed care experience
• Discharge planning experience
• Experience working with Medicaid population
• Spanish speaking
• Case Management Certification (CCM) preferred

Veterans Sourcing Group