Case Management Analyst - Field Illinois - Zion, Waukegan, Beach Park and surrounding area
Core
Facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education through care management tools and resources.
Role type
Case Management Analyst (Field)
Builds
Care plans and member engagement strategies for healthcare members
Domain
Healthcare / Behavioral Health / Social Services
Deliverable
client delivery
Required skills
Care coordination, care plan implementation, member evaluation, benefit plan analysis, quality of care monitoring, negotiation, motivational interviewing, coaching, regulatory compliance
Preferred skills
Discharge planning, Managed Care experience, Microsoft Office
Responsibilities
Conduct comprehensive evaluation of referred members' needs and eligibility; coordinate and implement assigned care plan activities; consult with case managers and medical directors to overcome barriers to goals; present cases at multidisciplinary conferences; identify and escalate quality of care issues; utilize negotiation skills to secure appropriate services; provide coaching to empower members for independent medical choices.
Seniority
Mid-level, hands-on IC