Nurse Case Manager II — Field & Home-Visit Specialist

SGS Consulting; Springfield (IL); Hybrid; USD 65,000 - 90,000; Full time

Job summary

SGS Consulting seeks a qualified healthcare professional for complex case management involving assessments of referred members in Illinois. The role requires interpreting benefit plans, determining appropriate services, and coordinating care with internal and external programs.

The ideal candidate holds RN, LCSW, or LCPC with an active IL license and is comfortable with up to 50–75% travel, working from home between visits. Strong organizational skills and independent work ethic are essential.

Qualifications

• RN, LCSW, or LCPC with current unrestricted IL state licensure.

Responsibilities

• Assess referred members' needs and eligibility and determine approach to case resolution.
• Interpret benefit plans and programs/services to ensure appropriate administration of benefits.
• Apply regulatory standards and company policies in managing benefits and coordinating care.
• Utilize case management and quality management processes in compliance with guidelines.

Skills

RN

LCSW

LCPC

Job description

SGS Consulting seeks a qualified healthcare professional for complex case management involving assessments of referred members in Illinois. The role requires interpreting benefit plans, determining appropriate services, and coordinating care with internal and external programs.

The ideal candidate holds RN, LCSW, or LCPC with an active IL license and is comfortable with up to 50–75% travel, working from home between visits. Strong organizational skills and independent work ethic are essential.