Registered Nurse, Case Manager

Job Description:

• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation
• Interacts with members/clients telephonically or in person
• May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services
• Travel can be up to 40% of the work week

Requirements:

• Must reside in the state of Illinois
• Must possess reliable transportation and be willing and able to travel up to 40% of the time from home location
• Minimum 3-5 years clinical practical experience
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
• 2-3 years Care Management, discharge planning and/or home health care coordination experience (Preferred)
• Certified Case Manager (Preferred)

Benefits:

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility

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