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Case Manager I (55781)
Springfield, IL
Job Description
Seeking RN, LSW, LCSW, LPC or LCPC with LTSS experience to be responsible for health care management and coordination of members to achieve optimal clinical, financial and quality of life outcomes. MUST reside in theSpringfield, IL area. Schedule M-F 8:00am-5:00pm.
Day to Day Responsibilities:Will be responsible for performing case management activities according to the contractual requirements and in alignment with NCQA requirements. Manage a caseload of approximately 130 LTC (Long Term Care) cases. Complete face-to-face visits with members in the LTC facilities at a minimum of an annual visit per member. Complete an annual assessment, assessment summary (DAR), care plan, and service plan per member. Collaborate with the LTC provider staff. Participates as needed in clinical care rounds.
Must Have Skills:
* Must have a valid driver's license and reliable vehicle for field visits
* Excellent communication skills, with an ability to communicate effectively with members with chronic conditions, developmental disabilities, etc.
* Strong technical skills (utilizing multiple programs at the same time) along with competency in Microsoft applications (Outlook, Teams, Excel, etc.)
* Strong organizational and interpersonal skills
Required Years of Experience: Preferred RN/LSW/LCSW/LPC/LCPC background, but not required if enough experience in related field (about 5+ years). Previous case management or MCO experience is a plus.
Required Licensure / Education: Bachelor's degree in nursing, social sciences, social work or related field or
Bachelor or master's degree prepared in human-services related field
It is the policy of the Company to provide equal employment opportunities to all qualified individuals and to administer all aspects and conditions of employment without regard to the following:
• Race and associated traits, including hairstyle; Color, Age, Sex, Sexual orientation, Gender, Gender identity and gender expression; Religion, including dress and grooming practices; National origin, including language use restrictions; Pregnancy, childbirth, or breastfeeding; Marital or familial status; Genetic information, including family medical history; Physical or mental disability; Citizenship and/or immigration status
• Medical conditions, including cancer, AIDS/HIV, and occupational pneumoconiosis without respiratory impairment
• Denial of family or medical care leave
• Use of a guide or support animal
• Military or veteran status
• Political activities or affiliations
• Exercise of civil rights
• Domestic violence, assault, or stalking victim status
• GED certificate
• Arrest, expunged, or sealed records
• Application for or enrollment in Medi-Cal
• Status as a smoker or non-smoker
• Credit report or credit information
• Child or spousal support withholding
• Wage garnishment for consumer debt
• Relationship with someone with a disability
• Lawful conduct occurring during nonworking hours not on Company premises
• Any other protected class, in accordance with applicable federal, state, and local laws
Discriminatory, harassing, or retaliatory behavior is prohibited from coworkers, supervisors, managers, owners, and third parties, including clientele. The Company takes allegations of discrimination, harassment and retaliation very seriously and will promptly conduct an investigation when warranted. Equal employment opportunity includes, but is not limited to, employment, training, promotion, demotion, transfer, leaves of absence and termination.
Day to Day Responsibilities:Will be responsible for performing case management activities according to the contractual requirements and in alignment with NCQA requirements. Manage a caseload of approximately 130 LTC (Long Term Care) cases. Complete face-to-face visits with members in the LTC facilities at a minimum of an annual visit per member. Complete an annual assessment, assessment summary (DAR), care plan, and service plan per member. Collaborate with the LTC provider staff. Participates as needed in clinical care rounds.
Must Have Skills:
* Must have a valid driver's license and reliable vehicle for field visits
* Excellent communication skills, with an ability to communicate effectively with members with chronic conditions, developmental disabilities, etc.
* Strong technical skills (utilizing multiple programs at the same time) along with competency in Microsoft applications (Outlook, Teams, Excel, etc.)
* Strong organizational and interpersonal skills
Required Years of Experience: Preferred RN/LSW/LCSW/LPC/LCPC background, but not required if enough experience in related field (about 5+ years). Previous case management or MCO experience is a plus.
Required Licensure / Education: Bachelor's degree in nursing, social sciences, social work or related field or
Bachelor or master's degree prepared in human-services related field
It is the policy of the Company to provide equal employment opportunities to all qualified individuals and to administer all aspects and conditions of employment without regard to the following:
• Race and associated traits, including hairstyle; Color, Age, Sex, Sexual orientation, Gender, Gender identity and gender expression; Religion, including dress and grooming practices; National origin, including language use restrictions; Pregnancy, childbirth, or breastfeeding; Marital or familial status; Genetic information, including family medical history; Physical or mental disability; Citizenship and/or immigration status
• Medical conditions, including cancer, AIDS/HIV, and occupational pneumoconiosis without respiratory impairment
• Denial of family or medical care leave
• Use of a guide or support animal
• Military or veteran status
• Political activities or affiliations
• Exercise of civil rights
• Domestic violence, assault, or stalking victim status
• GED certificate
• Arrest, expunged, or sealed records
• Application for or enrollment in Medi-Cal
• Status as a smoker or non-smoker
• Credit report or credit information
• Child or spousal support withholding
• Wage garnishment for consumer debt
• Relationship with someone with a disability
• Lawful conduct occurring during nonworking hours not on Company premises
• Any other protected class, in accordance with applicable federal, state, and local laws
Discriminatory, harassing, or retaliatory behavior is prohibited from coworkers, supervisors, managers, owners, and third parties, including clientele. The Company takes allegations of discrimination, harassment and retaliation very seriously and will promptly conduct an investigation when warranted. Equal employment opportunity includes, but is not limited to, employment, training, promotion, demotion, transfer, leaves of absence and termination.
Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
5+ years
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