Case Management Coordinator - Field - Southern IL
Core
Telephonically and/or face-to-face assess, plan, implement, and coordinate case management activities to evaluate medical needs and facilitate member wellness.
Role type
Case Management Coordinator
Builds
Member care plans and wellness strategies
Domain
Health insurance / Managed care
Required skills
Clinical judgment, interviewing skills, case management processes, claims review, benefit plan eligibility assessment, multidisciplinary case conference presentation, regulatory compliance
Preferred skills
Long term care experience, discharge planning experience, managed care experience, Microsoft Excel
Technologies
Microsoft Office (Excel)
Responsibilities
Develop proactive courses of action to enhance member wellness outcomes, conduct evaluations of member needs and benefit eligibility, apply clinical judgment to address complex health and social indicators, review prior claims, assess work capacity and restrictions, consult with supervisors and present cases at conferences, utilize interviewing skills for member engagement
Seniority
Mid-level, hands-on IC