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IL Nurse Case Manager (Remote)

Careerbuilder-US

This is a Full-time position in Chicago, IL posted January 7, 2021.

Responsibilities: nn The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’ s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company po licies and procedures nn n n Job Requirements: n nn Requirements: nn RN with current unrestricted state licensure in IL.

Required 3-5 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.

Healthcare and/or managed care industry experience.

Case Management experience preferred-
– Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written.

Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

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