Care Navigation and Coordination Specialist

Hillsboro Health; Hillsboro (IL); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Hillsboro Health is seeking a Care Coordinator to support patient care coordination and case management across the continuum of care. The role ensures timely services, regulatory compliance, and effective transitions, collaborating with care teams, payers, and community resources.

The ideal candidate will have an Illinois RN license, 2–5 years of clinical experience, and knowledge of case management and utilization review.

Qualifications

• Bachelor’s degree preferred.
• Case Management Certification preferred.

Responsibilities

• Delivers nursing care according to the Illinois Nurse Practice Act.
• Perform comprehensive patient assessments including medical, psychosocial, and legal needs.
• Develop individualized care plans with measurable goals and timeframes.
• Coordinate case management interventions with physicians, payers, and community agencies.
• Collaborate with healthcare providers to formulate care plans and provide patient education.
• Monitor and evaluate care plans; modify as needed based on patient outcomes.
• Facilitate multidisciplinary meetings and ensure continuity of care across settings.
• Assist with education on benefits, coverage, and public programs.
• Set up and coordinate Durable Medical Equipment (DME) needs.
• Audit patient charts for completeness and accuracy.
• Prepare documentation for Utilization Review daily.
• Interact with managed care organizations and conduct utilization review.
• Address psychosocial needs and family dynamics; assist with directives and referrals.
• Participate in process improvement initiatives to enhance care delivery.
• Conduct follow-up evaluations to identify issues impacting outcomes.
• Maintain organization and ability to work remotely for portions of duties.

Education

Bachelor’s degree preferred

Case Management Certification preferred

Job description

Hillsboro Health is seeking a Care Coordinator to support patient care coordination and case management across the continuum of care. The role ensures timely services, regulatory compliance, and effective transitions, collaborating with care teams, payers, and community resources.

The ideal candidate will have an Illinois RN license, 2–5 years of clinical experience, and knowledge of case management and utilization review.