Analyst Case Management - Field in DuPage County or Western Cook County Illinois
Core
Field-based case manager assessing, planning, and coordinating care activities to evaluate medical needs and facilitate member wellness.
Role type
Senior IC case manager (healthcare)
Builds
Integrated care plans and smooth transitions to Aetna programs
Domain
Healthcare / Insurance
Required skills
clinical judgment, case management, interviewing skills, data review, claims analysis, regulatory compliance
Preferred skills
integrated model case management, behavioral health experience, long-term care/nursing home experience
Technologies
MS Office suite
Responsibilities
Conduct face-to-face assessments of member needs and benefit eligibility, develop proactive courses of action to enhance wellness, apply clinical judgment to address complex health and social indicators, review prior claims for impact on case management, consult with supervisors and present cases at multidisciplinary conferences, utilize interviewing skills to discern health status and needs.
Seniority
Mid-level, hands-on IC