Nurse Case Manager II - RN Case Manager

Job Title: Nurse Case Manager II - RN Case Manager - Field Clinical Case Mgr II PCR

Project work; could extend past 90 days at this time based on need and interest.

Clinical Role
RN with current unrestricted state licensure in IL. REQUIRED

or

LCSW/LCPC in IL. REQUIRED

Field Based Position

MUST HAVE:
TARGET Counties/Geographic Areas:
Fulton County
DuPage County
Kane County (2 openings)
Cook County (2 openings)
West Suburban Cook County
IL resident who lives in one of the counties listed below and is interested in doing field case management with the elderly and individuals with disabilities who are approved for in-home or nursing facility care.

On each resume, please clearly list which city state county and zip code the candidate is applying for.

FIELD ROLE
Field Based Case Managers: Caseloads typically range from 30 to 100 members, depending on market needs and complexity of members needs.
Mileage reimbursement
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual\'s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
RN, LCSW, or LCPC with current unrestricted state licensure in IL. REQUIRED
Experience with case management.
Position will require travel to members\' homes up to 50-75% travel. Must live near areas listed due to travel requirement and will work at home in between visits. We want someone who is organized, efficient, and can work independently.
-Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services
-Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member\'s needs to ensure appropriate administration of benefits
-Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Duties
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services
Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate
administration of benefits
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Experience
3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
Healthcare and/or managed care industry experience.
Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Typical office working environment with productivity and quality expectations

Position Summary
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires an RN with unrestricted active license

Education
RN, LCSW, or LCPC with current unrestricted state licensure in IL. REQUIRED

What days & hours will the person work in this position List training hours, if different.
8am to 5pm Ct Mon-Fri