IL
Field Case Management Analyst
ICONMA, LLC
🇺🇸 United States
On-site
2 weeks ago
$15.00 – $34.12 / hour
- crisis intervention
2 weeks ago
Not enough detail in this posting to match
Responsibilities:
- Evaluation of Members:
- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members' needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members' benefit plan and available internal aid 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 knowledgeably 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.
Requirements:
- Preferred Qualifications:
- Case management and discharge planning experience
- Managed Care experience
- Microsoft Office experience
- Experience working with HIV and AIDS population
- Multi-lingual language proficiency
- Education:
- Individual with a bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Field Case Management Analyst · ICONMA, LLC