Analyst – Case Manager

Analyst – Case Manager

Requirements

• Minimum 2 years of Case Management experience.
• 2+ years experience in Behavioral health or Social Services
• 3+ years computer proficiency (MS Outlook, Excel, PowerPoint, and Word) and must navigate multiple systems simultaneously
• Required to work the standard hours – 8:30am-5pm CST.
• Willing and able to travel up to 25% of their time in Chicago (Cook County) IL and surrounding areas.

Responsibilities

• Conducts comprehensive evaluation of Members using care management tools and information/data review.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• In collaboration with the member and their care team develops and monitors established plans of care to meet the member’s goals.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Preferred Qualifications

• Managed Care Organization experience is strongly preferred.
• CCM Certification (Certified Case Manager) preferred
• Crisis intervention skills/experience
• Discharge Planning experience
• Strong organization and time management skills. Must be highly organized to manage continuously changing priorities.
• Strong verbal and written communication skills.