Case Manager I (BEP Illinois)

Lancesoft; Illinois; Hybrid; USD 45,000 - 65,000; Full time

Job summary

Lancesoft is seeking a Case Manager I for the Metro East, IL area on a hybrid schedule. You will complete member assessments, coordinate waiver enrollment, and develop care plans with caregivers and health professionals while monitoring progress.

The role requires at least 2 years of health care experience with LTSS exposure, plus 1 year in care management or related settings. Travel of 25-40% may be required; schedule is Monday–Friday 8:00 AM–5:00 PM CST; 3+ month project with W2 hourly pay of

Qualifications

• At least 2 years health care experience, including LTSS exposure.
• 1 year of experience in care management or equivalent setting.

Responsibilities

• Completes comprehensive member assessments within regulatory timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians, and the care network to address needs and goals.
• Monitors care plan effectiveness, documents interventions, and suggests adjustments as needed.
• Promotes integration of services including behavioral health and LTSS to ensure continuity of care.
• Assesses medical necessity and authorizes waiver services as appropriate.
• Facilitates ICT meetings for service approvals/denials and collaboration.
• Uses motivational interviewing to educate and support member changes.

Skills

Healthcare experience

Care coordination

LTSS experience

Motivational interviewing

Job description

Job Title: Case Manager I
Location: Hybrid, Metro East: St Clair, IL (25-40% estimated local travel)
Duration: 03+ Months
Offered Rate: $40 hourly on W2
Schedule: M-F 8-5 CST

Day to Day Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesss for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).

Must Have Requirements

At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience