Previous Job
Case Manager 2
Ref No.: 18-28988
Location: Chicago, Illinois
Description/Comment:Evaluation of Members:-
Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
Identifies and escalates quality of care issues through established channels.
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/
behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Helps member actively and knowledgably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care:- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Exhibits the following Case Management Coordinator Behaviors

Background/Experience Desired
• Managed Care experience preferred
• Case management and discharge planning experience preferred
• 2 years experience in behavioral health, social services or appropriate related field equivalent to program focus

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

Additional Job Details:
1. The candidate must be self-motivated and independent
2. This position will be based out of downtown Chicago office location.
3. The candidate's coverage area includes, but is not limited to, the Bronzeville area.
The ideal candidate would live in or be willing to travel to this area.