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IL

Case Manager

ICONMA, LLC
🇺🇸 United States
Remote
Manager or above
5 months ago
$31.55 – $41.08 / hour
  • Excel
  • OneNote
  • Outlook
  • Health insurance
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Our Client, a Health Insurance company, is looking for a Case Manager for their Remote location.
 
Responsibilities:
  • Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally.
  • The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors.
  • Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members’ health across the care continuum.
  • Assess the member's health, psychosocial needs, cultural preferences, and support systems.
  • Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.
  • Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services).
  • Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
  • Advocate for members and promote self-advocacy.
  • Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
  • Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.
  • Accurately document interactions that support management of the member.
  • Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
  • Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
  • Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
  • Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.
  • Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).
 
Requirements:
  • Nursing Diploma or Associates degree in nursing required.
  • Bachelor’s degree in nursing strongly preferred.
  • 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
  • 1 year of case management experience in a managed care setting strongly preferred.
  • Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
  • The requirements listed below are representative of the knowledge, skill, and/or ability required.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
  • Ability to think critically, be clinically curious, be decisive, and problem solve a variety of topics that can impact a member’s outcomes.
  • Empathetic, supportive and a good listener.
  • Proficient in motivational interviewing skills.
  • Demonstrated time management skills.
  • Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member.
  • Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).
  • Must embrace teamwork but can also work independently.
  • Excellent interpersonal and communication skills both written and verbal.
  • Current, active, and unrestricted Multistate Compact Registered Nurse license required
  • States in which we are managing related to this posting:
  • Delaware, Georgia, Maine, North Carolina, New Hampshire, New Jersey, Ohio, Virginia and West Virginia.
  • Certification in Chronic Care Professional (CCP) and Certification in Case Management (CCM) preferred
 
Why Should You Apply?
  • Health Benefits
  • Referral Program
  • Excellent growth and advancement opportunities
 
ICONMA is an Equal Opportunity Employer. All qualified applicants will receive considerationfor employment without regard to any status protected by applicable law.
 

Case Manager · ICONMA, LLC

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