Job Description

Position:- Care Management Specialist II

Rate:- $40/hr.

Location:-

Remote

in

Chicago

, IL

(This position will not necessarily require travel, but very, very rarely they may need to & onsite training is required )

Required License

:-

LCPCs/LCSWs if possible

(RNs are fine but must have at least 2 years exp working in a behavioral health setting).

Job Discription:-
This position is responsible for discharge care coordination, episodic case management and pre-admission/post-discharge counseling for an acute condition. This position is responsible for handling duties in an independent manner and may assist other staff. Establish relationship with the member through the immediate post discharge follow-up period or until all short term care needs are met. Provide education/local resource information and encourage member (self) education. Determine case complexity and refer to other internal departments as needed

Essential Functions:

Coordinate discharge planning, episodic case management, and counseling to identify treatment options and reduce readmissions and ER visits. Collaborate with physicians, providers, coordinators, and facility discharge planners to assess needs and create appropriate care plans. Support transition-of-care needs, including outreach, risk assessment, medication reconciliation, reinforcing post-operative instructions, and addressing barriers to follow-up care. Assist members with scheduling appointments, finding primary/specialist providers, navigating the healthcare system, and accessing community resources (home health, transportation, BCC programs, etc.). Conduct face-to-face interventions when required and provide education to encourage self-management and behavior change. Identify quality-of-care concerns and refer cases to QA/QI. Perform Transition of Care services across all assigned lines of business and refer complex cases to specialized departments. Practice within licensure, maintain required credentials, and support new employee orientation. Ensure compliance with HIPAA and corporate policies, maintain confidentiality, and communicate developments to management.

Job Requirements:

JOB REQUIREMENTS:

Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with current, active, unrestricted license in the state of operations (or reciprocity if applicable). 2 years clinical experience. 1 year health insurance/managed care experience.? Knowledge of medical management policies and procedures. Knowledge of medical management procedures; strong PC, communication, and customer service skills. Ability to travel locally with valid driver's license.
Job Type: Contract

Pay: $40.00 per hour

Expected hours: 40 per week

Benefits:

Referral program
Experience:

clinical experience in behavioral health: 2 years (Required) Patient Education: 1 year (Required)
Work Location: Remote