Government Programs Care Manager II – 743 – Work From Home

HCSC • Downers Grove, IL

4d • Remote

About The Position

This position provides care coordination to members through telephonic and/or field-based care management, informing and educating them about health care programs that address their personal health needs. The role engages members in discussions about adherence to personal health goals, responds to member inquiries, and supports clinical operations as well as provider and member activities. Duties include completing telephonic and/or field-based health screenings, comprehensive health assessments, and care planning, which may involve visits to members’ homes and/or facilities. This is a remote/work-from-home field-work role that requires travel within the assigned territory, including Cook and Collar counties. The position may be performed remotely from anywhere in the continental United States except California, New York, Alaska, and Hawaii. Work hours are 8:00 AM to 4:30 PM CST, Monday through Friday. Sponsorship is not available. This is a union role.

Requirements

• Hold an unrestricted license in an eligible clinical profession: Registered Nurse (RN); Licensed Professional Counselor (LPC, Texas); Licensed Master Social Worker (LMSW, Texas); Licensed Clinical Professional Counselor (LCPC, Illinois); Licensed Clinical Social Worker (LCSW, Illinois or New Mexico); Licensed Marriage and Family Therapist (LMFT, Illinois or New Mexico); Licensed Professional Clinical Counselor (LPCC, New Mexico); Licensed Independent Social Worker (LISW, New Mexico); Licensed Social Worker (LSW, Illinois); or Licensed Mental Health Counselor (LMHC, New Mexico).
• Maintain a current, valid, unrestricted license in the state of operations or reciprocity. Compact licensees changing permanent residence to the state of operations must obtain active, unrestricted RN licensure in that state within 90 days of hire.
• Have at least 3 years of wellness or managed care experience presenting clinical issues to members and physicians.
• Have knowledge of the health and wellness marketplace and employer trends.
• Have verbal and written communication skills, including discussing medical needs with members and interfacing with internal staff and management, external vendors, and community resources.
• Have analytical experience, including medical data analysis.
• Be proficient with PCs, including Word, Excel, and PowerPoint, and have database and web-based application experience.
• Have a current unrestricted driver’s license, transportation, and applicable insurance.
• Be able and willing to travel within the assigned territory.
• For Illinois high-needs children work only: have a bachelor’s degree in nursing, social sciences, social work, or a related field, and one year of supervised clinical experience in a human-services field.

Nice To Haves

• Direct clinical experience.
• Patient education experience.
• Condition Management experience.
• Bilingual proficiency in English and Spanish.
• Experience managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management, or a nationally recognized health care certification.
• Government Programs experience.

Responsibilities

• Provide telephonic and/or field-based care coordination to members.
• Inform and educate members about health care programs addressing their personal health needs.
• Engage members in discussions about adherence to personal health goals.
• Respond to member inquiries.
• Support clinical operations and provider and member activities.
• Complete member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning.
• Travel within the assigned territory, including Cook and Collar counties, and make visits to members’ homes and/or facilities as needed.

What This Job Offers

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