Case Management Consultant

US Tech Solutions • Chicago, IL

5d • Remote

About The Position

This role involves facilitating appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support, and education. The consultant will use care management tools and resources to deliver comprehensive healthcare management services, aiming to facilitate appropriate healthcare treatment, effectively manage healthcare costs, and improve healthcare program/operational efficiency. Key aspects include determining medical necessity and appropriateness, facilitating optimal outcomes, identifying and addressing quality/compliance opportunities, and potentially identifying aberrations and initiating corrective actions. The role also involves educating and empowering customers to ensure compliance, satisfaction, and promote patient advocacy, while optimizing total costs. Policy implementation and evaluation based on usage and program directives, as well as educating colleagues at all levels to enable decision-making, are also part of the responsibilities. This is a remote position that requires significant travel (50-75%) to meet members face-to-face in the western Chicago suburbs and surrounding areas, utilizing personal transportation.

Requirements

• Minimum 2 years of relevant experience in behavioral health or social services field, or human services
• Must have 2+ years of experience in case management
• Must be willing and able to travel using your own vehicle 50-75% of their time to meet with members face to face in western Chicago suburbs and surrounding areas
• Must have reliable transportation and a driver’s license

Responsibilities

• Determines medical necessity/appropriateness
• Facilitates optimal outcomes
• Identifies and follows through with continuous quality/compliance opportunities
• May also include identification of aberrances and initiation of corrective action
• Educates/empowers customers to ensure compliance, satisfaction and promote patient advocacy
• Optimize total costs
• Implementation and evaluation of policy based on usage and program directives
• Educate/empower colleagues at all levels to enable decision making at most appropriate level

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level