Case Manager Registered Nurse, Assessor Team (Remote , Illinois)

Program Overview

• Help elevate patient care by serving dual-eligible Medicare and Medicaid populations with complex health and social challenges.
• Collaborate with members, providers, and community organizations to address comprehensive health and social determinant needs.
• Utilize a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy.

Key Responsibilities

• Develop proactive plans of care to enhance short- and long-term outcomes and overall wellness.
• Conduct evaluations of member needs and benefits using clinical tools and data review.
• Apply clinical judgment to reduce risk factors, address barriers, and handle co-morbid diagnoses.
• Assess the need for clinical resources and interdisciplinary team referrals using a holistic approach.
• Collaborate with supervisors and stakeholders, participating in interdisciplinary case conferences.
• Comply with regulatory and company case management policies.
• Use motivational interviewing skills for maximum member engagement.

Qualifications

• Active and unrestricted Registered Nurse license in Illinois.
• Minimum 3-5 years of clinical practical experience.
• Experience in Care Management, discharge planning, and/or home health care coordination preferred.
• Certified Case Manager (CCM) preferred.
• Proficiency with standard corporate software (MS Word, Excel, Outlook, PowerPoint).
• Ability to work independently from home in Illinois.