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Case Manager 2
Ref No.: 18-13365
Location: Chicago, Illinois
Start Date / End Date: 10/22/2018 to 02/21/2019
Duration:0-4 month(s)

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.

Additional Job Details: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). 1. The candidate must be self-motivated and independent 2. This position will be based out of the Chicago office location.