Case Manager I (BEP Illinois)

Lancesoft; Rockford (IL); Hybrid; USD 45,000 - 65,000; Full time

Job summary

Lancesoft in Rockford, IL is seeking a Case Manager I for a hybrid role with local travel (25-40%). The role supports coordinated care for members with disabilities and chronic conditions under LTSS, including waiver management and care planning.

Requires at least 2 years of healthcare experience, with 1 year in care management or related field; strong skills in multidisciplinary collaboration, motivational interviewing, and care coordination are essential to drive outcomes and continuity of

Qualifications

• At least 2 years health care experience, including LTSS and 1 year in care management or equivalent.
• Experience working with persons with disabilities/chronic conditions is a plus.

Responsibilities

• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates waiver enrollment and disenrollment processes.
• Develops and implements care plans with members, caregivers, physicians and support networks.
• Monitors and documents progress, adjusting care plans as needed.
• Promotes integration of behavioral health and LTSS services and connects members to home and community resources.
• Assesses medical necessity and authorizes waiver services.
• Evaluates benefits and advises on funding sources.
• Facilitates ICT meetings for service approvals/denials.
• Educates and motivates members using motivational interviewing.
• Identifies barriers to care and coordinates solutions for psycho/social, financial, and medical obstacles.
• Identifies critical incidents and develops prevention plans to protect member health.

Skills

Care coordination

Care management

Motivational interviewing

Interdisciplinary collaboration

Job description

Job Title: Case Manager I Location: Hybrid, Rockford, IL,61108 (25-40% estimated local travel) Duration: 03+ Months Offered Rate: $40 hourlyon W2 Schedule: M-F 8-5

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 clinical guideposts to educate, support and motivate change during member contacts.
• Assesses 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.