Case Manager

Integrated Resources Inc.; Downers Grove (IL); On-site; USD 45,000 - 65,000; Full time

Job summary

A healthcare staffing company in Downers Grove, Illinois, is seeking a Case Coordinator to evaluate and support Medicaid members. The ideal candidate will utilize critical thinking and negotiation skills to facilitate healthcare outcomes and engage members effectively in their care decisions. This role emphasizes collaboration with case managers and requires a passion for assisting clients in navigating healthcare services.

Qualifications

• Experience with Medicaid or healthcare-related case management processes.
• Ability to engage and motivate clients in making informed healthcare decisions.
• Familiarity with care management tools and documentation.

Responsibilities

• Evaluate and support Medicaid members in the case management process.
• Consult with case managers to enhance quality of care.
• Provide coaching and information to members.

Skills

Critical thinking

Negotiation skills

Influencing skills

Organizational ability

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

Provide Case Coordination to Medicaid Members. Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.

Essential Functions:

• Evaluation of Members:-Through the use of care management tools and information/data review, conducts
• Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with case managers,
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Monitoring, Evaluation and Documentation of Care:- Utilizes case management and quality management processes in
• Demonstrates skills of flexibility, independence, organizational ability, willingness to work with a team and passion for assisting class members of the Colbert Consent Decree.

Additional Information

All your information will be kept confidential according to EEO guidelines.