Case Manager Registered Nurse (Field - Must reside in Woodford or McLean Counties Illinois)

About the position

This is a field based position with 50-75% of travel to meet members face to face in Woodford and McLean Counties, and surrounding areas. Applicants must reside in Woodford or McLean County. Monday- Friday 8am-5pm. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meet contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.

Responsibilities

• Conduct comprehensive evaluation of referred members' needs/eligibility and recommend an approach to case resolution.
• Identify high risk factors and service needs that may impact member outcomes and care planning components.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement.
• Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Help member actively and knowledgeably participate with their provider in healthcare decision-making.
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines.

Requirements

• 2+ years of clinical experience
• Active and good standing Illinois RN license
• Must possess reliable transportation and be willing and able to travel 50-75% of the time.
• Must reside in Woodford or McLean County

Nice-to-haves

• Case Management and Discharge Planning experience preferred
• Managed Care experience preferred
• Microsoft Office experience preferred

Benefits

• Full range of medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Paid Time Off (PTO) or vacation pay
• Paid holidays throughout the calendar year