Hybrid Case Manager, Registered Nurse

Posted 1 hour ago

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About the role

  • Case Manager RN coordinating health services for Medicare and Medicaid populations. Collaborating with members and providers to meet health and social needs in Illinois.

Responsibilities

  • Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
  • Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
  • Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
  • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care
  • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate
  • Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person
  • Prepares all required documentation of case work activities as appropriate
  • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
  • Provides educational and prevention information for best medical outcomes
  • Utilizes case management processes in compliance with regulatory and company policies and procedures
  • Monitors member/client progress toward desired outcomes through assessment and evaluation.

Requirements

  • Minimum 3-5 years clinical practical experience preference required
  • Minimum 2-3 years CM, discharge planning and/or home health care coordination experience
  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Ability to work independently
  • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
  • Efficient and Effective computer skills including navigating multiple systems and keyboarding
  • Candidates must live in or near Arlington Heights, Rolling Meadows, Glenview, Palatine, Mount Prospect, Northbrook, Wooddale, Prospect Heights
  • Must possess reliable transportation and be willing and able to travel up to 75% of the time.

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Job title

Case Manager, Registered Nurse

Job type

Experience level

Mid levelSenior

Salary

$66,575 - $142,576 per year

Degree requirement

Associate's Degree

Location requirements

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