Case Management Analyst – Field in St. Clair County Illinois or Surrounding Areas
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
Domain
Health insurance / Behavioral health
Deliverable
dashboards & analysis
Required skills
Care coordination, Care plan implementation, Member evaluation, Quality of care monitoring, Negotiation, Motivational interviewing, Data review, Regulatory compliance
Preferred skills
Discharge planning, Managed care, Microsoft Office
Responsibilities
Conduct comprehensive evaluation of referred members' needs and eligibility; Identify high risk factors and service needs; Coordinate and implement assigned care plan activities; Consult with medical directors and present cases at conferences; Escalate quality of care issues; Provide coaching to empower members for healthy lifestyle choices.
Seniority
Mid-level, hands-on IC