Case Management Analyst - Field in St. Clair County IL or 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 Coordinator (Healthcare)
Builds
Care plans and member support strategies
Domain
Healthcare / Managed Care
Required skills
Care management, benefit plan evaluation, care plan implementation, quality management processes, negotiation, motivational interviewing, coaching, data review, electronic health record usage
Preferred skills
Discharge planning, managed care experience
Responsibilities
Conduct comprehensive evaluation of referred members' needs and eligibility; identify high-risk factors and service needs; coordinate and monitor assigned care plan activities; consult with multidisciplinary teams to overcome barriers to goals; escalate quality of care issues; provide coaching and support to empower members; utilize case management processes in compliance with regulatory guidelines.
Seniority
Mid-level, hands-on IC