Job Title: Case Manager Location : Remote + Traveling to any nearby area of Danville IL
Duration – 3 Months **Candidate must be located in/near Danville, IL for consideration** Seeking candidate with LVN, Social Worker, MSW licensure. Must have active license in State of IL 75% travel required for position Summary: Responsible for health care management and coordination of Client Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Client member's progress and services to ensure consistent cost effective care that complies with Client policy and all state and federal regulations and guidelines. Essential Functions: • Provides case management services to members with chronic or complex conditions including: o Proactively identifies members that may qualify for potential case management services. o Conducts assessment of member needs by collecting in-depth information from Client's information system, the member, member's family/caregiver, hospital staff, physicians and other providers. o Identifies, assesses and manages members per established criteria. o Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. o Performs ongoing monitoring of the plan of care to evaluate effectiveness. o Documents care plan progress in Client's information system. Knowledge/Skills/Abilities: • Demonstrated ability to communicate, problem solve, and work effectively with people. • Excellent organizational skill with the ability to manage multiple priorities. • Work independently and handle multiple projects simultaneously. • Strong analytical skills. • Knowledge of applicable state, and federal regulations. • Knowledge of ICD-9, CPT coding and HCPC. • SSI, Coordination of benefits, and Third Party Liability programs and integration. • Familiarity with NCQA standards, state/federal regulations and measurement techniques. • In depth knowledge of CCA and/or other Case Management tools. • Ability to take initiative and see tasks to completion. • Computer skills and experience with Microsoft Office Products. • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). • Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers. Required Education: Bachelor's degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree). Required Experience: 0-2 years of clinical experience with case management experience. Required Licensure/Certification: Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW. Must have valid driver's license with good driving record and be able to drive locally.
PandoLogic. Category: Social Services, Keywords: Case Manager