Case Management Coordinator - Field (Will County, IL)

Evaluation of Members

The Case Management Coordinator conducts comprehensive evaluations of members' needs/eligibility using care management tools and information/data review. They recommend approaches to case resolution and care planning, identifying high-risk factors and service needs that may impact member outcomes. Referrals to clinical case management or crisis intervention are made as appropriate.

Enhancement of Medical Appropriateness and Quality of Care

• Consults with case managers, supervisors, Medical Directors, and other health programs to resolve barriers and achieve optimal outcomes.
• Presents cases at case conferences for multidisciplinary review.
• Escalates quality of care issues through established channels.
• Uses negotiation skills to secure appropriate options and services.
• Utilizes influencing/motivational interviewing skills to promote lifestyle/behavior changes.
• Engages in ongoing team meetings and offers peer mentoring/training.
• Empowers members to make informed healthcare decisions.

Monitoring, Evaluation and Documentation of Care

The Case Management Coordinator uses case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Documentation is done in accordance with these standards.

Qualifications

• 2+ years of experience in Behavioral Health, Social Services, or a related field.
• A Bachelor's degree or non-licensed master level clinician degree in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counseling).
• Reliable transportation and willingness to travel 50-75% of the time in Will County, Illinois.
• Experience with electronic documentation and Microsoft Office applications.