Hiring for Field Case Manager in St. Clair County, IL

Lancesoft; Springfield (IL); Hybrid; USD 41,000 - 47,000; Full time

Job summary

Lancesoft is seeking a Healthcare Consultant I for a contract/fulltime role located in St. Clair County, IL. The position is hybrid, with travel up to 75% to meet members face to face and the remainder remote.

The analyst will manage full caseloads, coordinate care plans, and provide education and support to waiver/LTSS members, ensuring outcomes align with regulatory guidelines and company policy.

Qualifications

• Must reside in Illinois in St. Clair County area.
• Valid Illinois Driver’s license.
• Willing and able to travel up to 75% of time to meet with members face to face.
• Reliable transportation, eligible for mileage reimbursement as per company policy.
• Minimum of two years of case management experience.
• Microsoft Office and electronic health record experience.

Responsibilities

• Evaluate referred members' needs/eligibility and recommend a case resolution approach.
• Identify high risk factors and facilitate appropriate referrals and care plans.
• Coordinate and implement care plan activities and monitor progress.
• Provide coaching, information and support to empower members in healthcare decisions.
• Ensure documentation complies with regulatory and company policies.

Skills

Case management

Care coordination

Interpersonal communication

Education

Bachelor's degree or Master's degree in human-services

Tools

Microsoft Office

Electronic Health Records (EHR)

Job description

Job ID: 26-129287 Job title: Healthcare Consultant I Position type: Contract/ fulltime role Location: St. Clair County, IL Work type: Hybrid (travel up to 75% of their time to meet with members face to face, rest work from home) Est. Pay range: $30.00/hour –$34.13/Hour on W2 (USD) (all inclusive) Schedule: Monday - Friday 8a-5p

Description

Add city state and zip to top of resume Must reside in the state of Illinois in St Clair County, Illinois area

• Valid Illinois Driver’s license
• Willing and able to travel up to 75% of their time to meet with members face to face
• Reliable Transportation required, eligible for mileage reimbursement as per company policy.
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience

This Analyst, Case Management Field position is with Client’s Long-Term Services & Supports (LTSS) team and is a field-based position out of the xxxx area of Illinois.

The requirements is for candidates to travel 50-75% of the time to meet with members face to face.

This position holds a full caseload to manage waiver members.

This position requires in person quarterly visits with members.

This position is critical to meet contractual requirements.

Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.

Position Summary

This Analyst, Case Management Field position is with Client’s Long Term Services & Supports (LTSS) team and is a field-based position out of the St.Clair County area of Illinois.

The requirements is for candidates to travel 50-75% of the time to meet with members face to face.

This position holds a full caseload to manage waiver members.

This position requires in person quarterly visits with members.

This position is critical to meet contractual requirements.

Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.

Duties

Evaluation of Members

• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members'needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members'benefit plan and available internal aid and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care

• o Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives;presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• O Identifies and escalates quality of care issues through established channels.
• O Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• O Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• O Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• O Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care

• o Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Evaluation of Members

• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members'needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members'benefit plan and available internal aid and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care

• o Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives;presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• O Identifies and escalates quality of care issues through established channels.
• O Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• O Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• O Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• O Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care

• o Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Experience

• Must reside in the state of Illinois in St. Clair County IL area
• Valid Illinois Driver’s license
• Willing and able to travel up to 75% of their time to meet with members face to face
• Reliable Transportation required, eligible for mileage reimbursement as per company policy.
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience

Preferred Qualifications

• Case management and discharge planning experience
• Managed Care experience
• Microsoft Office experience
• Experience working with HIV and AIDS population
• Multi-lingual language proficiency

Education

Individual with a bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)