Analyst, Case Management – Field – Central or North Cook County IL or Surrounding Areas

CVS Health•Oak Park, IL

2d•$21 - $45•Hybrid

About The Position

This position is for a Transition Coordinator for the Transition Team. The Transition Coordinator will be assigned to Central and North Cook County Nursing Home and SMHRF to meet with ABH-IL members, to assist with transition to the community. Strongly prefers candidates located in Central or North Cook County IL. Transition Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: As a Transition Coordinator, they will assist with transition of the members back to the community from the nursing home. Identify with members their needs and service needs that may impact member's outcomes. Coordinates with the RNCM, BHCM, and the rest of care team to ensure interventions are put into place to support members before and after discharge from the nursing home. Enhancement of Medical Appropriateness and Quality of Care: 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. Identifies and escalates quality of care issues through established channels. Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes incompliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

2 years of Case management and/or discharge planning experience.
2 years' experience in behavioral health, social services or human services field.
Must reside in Central and North Cook County, IL and surrounding areas.
Willing and able to travel up to 75% of their time to meet members face to face in person at nursing home facilities and community locations (Ex - government offices; housing tours etc.) in Central and North Cook County, IL and surrounding areas.
Reliable transportation required.

Nice To Haves

Long term care experience
Knowledge of Colbert/Williams Consent Decree

Responsibilities

Assist with transition of the members back to the community from the nursing home.
Identify with members their needs and service needs that may impact member's outcomes.
Coordinates with the RNCM, BHCM, and the rest of care team to ensure interventions are put into place to support members before and after discharge from the nursing home.
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.
Identifies and escalates quality of care issues through established channels.
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Helps member actively and knowledgably participate with their provider in healthcare decision-making.
Utilizes case management and quality management processes incompliance with regulatory and accreditation guidelines and company policies and procedures.