Our Client, a Retail Pharmacy company, is looking for a Field Case Management Coordinator for their McLean, De Witt, Macon, Champaign, Douglas, Shelby and surrounding counties, IL location.
Responsibilities:- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
- 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.
- Coordinates and implements assigned care plan activities and monitors care plan progress.
- 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.
- 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.
- 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.
- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Requirements:- Case management experience preferred
- 2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
- Managed Care experience preferred
Why Should You Apply?