Case Management Coordinator - Field (Franklin, Williamson, Union and southern counties, IL)
Core
A Case Management Coordinator evaluates member needs, coordinates care plans, and facilitates healthcare outcomes by accessing benefits and resources.
Role type
Case Management Coordinator
Builds
Care plans and member engagement strategies
Domain
Health insurance / Behavioral health
Required skills
Critical thinking, Judgment, Care plan coordination, Benefit access navigation, Negotiation, Motivational interviewing, Coaching, Documentation, Team collaboration, Data review
Preferred skills
Case management, Discharge planning, Managed Care
Technologies
Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
Responsibilities
Evaluate member needs and eligibility using care management tools; Identify high-risk factors and refer to clinical case management; Coordinate and monitor assigned care plan activities; Consult with medical directors and present cases at conferences; Escalate quality of care issues; Secure appropriate services through negotiation; Provide coaching to empower members; Engage in team meetings and peer mentoring; Monitor and document care in compliance with guidelines.
Seniority
Entry-level to Mid-level, hands-on IC