Case Management Coordinator

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

As a Case Management Coordinator, you will facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members through the use of care management tools and resources.

Travel Requirements: Travel is required 50-75% of the time within Lake County, IL.

Evaluation of Members:

• Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and information/data review.
• Recommend approaches to case resolution and/or meeting needs by evaluating members' benefit plans and available internal and external programs/services.
• Identify high-risk factors and service needs that may impact member outcomes and care planning components, making appropriate referrals to clinical case management or crisis intervention.
• Coordinate and implement assigned care plan activities and monitor care plan progress.

Enhancement of Medical Appropriateness and Quality of Care:

• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers to meeting goals and objectives.
• Present cases at case conferences for multidisciplinary review to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services necessary to meet members' benefits and/or healthcare needs.
• Employ influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve an optimum level of health.
• Provide coaching, information, and support to empower members to make ongoing independent medical and/or healthy lifestyle choices.
• Help members actively and knowledgeably participate with their providers in healthcare decision-making.

Monitoring, Evaluation, and Documentation of Care:

• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications:

• Reside in Lake County, IL.
• Minimum 2 years of experience in behavioral health, social services, or human services field.
• Minimum 2 years of case management experience.
• Willing and able to travel using your own vehicle up to 50-75% of the time to meet members face-to-face in Lake County, IL, and surrounding areas.
• Reliable transportation required; mileage is reimbursed per company expense reimbursement policy.

Preferred Qualifications:

• Discharge planning experience.
• Managed Care experience.
• Microsoft Office experience.

Education:

• Bachelor's degree or non-licensed master-level clinician required, with either degree being in behavioral health or human services (psychology, social work, marriage and family therapy, counseling).

Anticipated Weekly Hours: 40

Time Type: Full-time

Pay Range: $21.10 - $44.99

Benefits: This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.