Job Title: Healthcare Case Manager I - Remote | WFH Job Overview We are looking for a motivated and compassionate Healthcare Case Manager I to join our dedicated team. This remote position is open to candidates residing within Chicago Cook County, IL. In this role, you will play a crucial part in assisting individuals in long-term care (LTC) by guiding them through their unique challenges and supporting them in achieving their personal goals.

Key Responsibilities

Conduct thorough assessments of members in adherence to mandated timelines. Collaborate with each member s support network to formulate and execute tailored case management plans. Provide insight on covered benefits and navigate funding sources to enhance member support. Lead interdisciplinary care team (ICT) meetings to discuss service approvals and promote teamwork. Identify and address barriers to care, offering assistance with psychosocial, financial, and medical issues. Detect critical incidents and devise prevention strategies to safeguard members health and well-being. Ensure seamless care coordination to facilitate access to necessary services for members. Required Skills Strong analytical and problem-solving abilities. Familiarity with applicable state and federal regulations. Understanding of ICD-9, CPT coding, and HCPC. Knowledge of SSI processes, coordination of benefits, and third-party liability programs. Experience with NCQA standards and measurement techniques. Proficiency in utilizing case management tools such as CCA or similar systems.

Qualifications

Bachelor's degree in Nursing, or a Master's degree in Social Work, Health Education, or a closely related discipline. An active and unrestricted State Registered Nursing license OR Licensed Clinical Social Worker (LCSW) OR Advanced Practice Social Worker (APSW) in good standing. 0-2 years of clinical experience, particularly in case management.

Career Growth Opportunities

This role offers exceptional potential for professional development, enabling you to refine your skills while making a significant impact in the lives of individuals who require support. You will be part of a collaborative environment that fosters growth and advancement. Company Culture And Values Our organization is committed to fostering a compassionate and inclusive workplace where collaboration, mutual respect, and personal development are paramount. You will be joining a team dedicated to making a real difference in the lives of others. Ready to advance your career? Apply now and become part of our mission to transform lives one case at a time! Employment Type: Full-Time Apply Job!