Case Management Analyst – Field

Case Management Analyst – Field

Requirements

• Candidate must reside in Macon/Piatt/Champaign County, IL
• Minimum 2 years of experience in behavioral health, social services or human services field
• Minimum 2 years of case Management experience.
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet members face to face in Macon County IL area. Mileage is reimbursed per our company expense reimbursement policy
• Bachelor’s Degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (psychology, social work, marriage and family therapy, counseling or related field)

Responsibilities

• Facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
• Conduct comprehensive evaluation of referred member’s needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
• Identify 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.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilize influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Help member actively and knowledgeably participate with their provider in healthcare decision-making.
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Preferred Qualifications

• Discharge planning experience
• Managed care experience
• Microsoft Office experience