Job Description
Are you a compassionate and driven Licensed Clinical Social Worker (LCSW), Licensed Clinical Professional Counselor (LCPC), or Licensed Professional Counselor (LPC) in Illinois? Do you thrive in a remote work environment and are passionate about empowering individuals to achieve their health and wellness goals? If so, we'd love to hear from you!
We're seeking a dedicated Clinical Case Manager to join our Value-Based Care Services team. In this role, you'll be a vital partner in helping our members navigate the healthcare system, enhance their quality of life, and maximize their overall well-being. You'll work collaboratively with members and healthcare providers to promote wellness, solve problems, and assist members in reaching their personal health-related goals.
What You'll Do:
Empower Members: Conduct telephonic outreach to members and providers, providing guidance and support to help them achieve their health and wellness goals.
Data-Driven Insights: Pull, sort, and analyze data to identify members who would benefit from our Population Health Management Program.
Comprehensive Case Management: Manage case assignments, including outreach, thorough documentation, ongoing monitoring of case progress, and effective case closure.
Collaborative Care: Coordinate and deliver timely, effective, equitable, safe, and member-centric care, adhering to HMO processes.
Problem-Solving and Support: Address barriers, social determinants of health, member motivators, and psychosocial issues to help members achieve wellness and health autonomy.
Healthcare Navigation: Educate members on navigating the HMO and the broader healthcare spectrum, promoting quality and cost-effective interventions and outcomes.
Operational Support: Contribute to the operational aspects of the division to meet organizational customer requirements and satisfaction.
Confidentiality and Compliance: Maintain strict confidentiality of all computer programs, medical records, and data, and ensure compliance with federal, state, and NCQA standards, as well as company policies and procedures.
Quality Improvement: Participate in QM/UM Committee Meetings (if applicable), including material preparation, minute-taking, data collection and analysis, reporting, and follow-up tasks, which may require occasional in-person attendance.
On-Call Rotation: Participate in an off-hours/weekend call rotation, as needed.
Professional Development: Commit to ongoing professional growth and education, staying up-to-date with current case management standards and your licensure's practice act.
Adaptability: Handle other responsibilities as assigned and adapt to changes in annual program requirements.
What You'll Need:
Current Illinois LCSW, LCPC, or LPC licensure.
Minimum of five years of experience in diverse healthcare settings or a Managed Care Organization.
Solid understanding of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.
Excellent clinical judgment, as well as strong verbal and written communication skills.
Exceptional organizational, problem-solving, and time management abilities.
Ability to prioritize and adapt to rapidly changing business needs.
Proven ability to work independently and remotely, with strong multitasking skills in a fast-paced environment.
Proficiency in software applications, including word processing and spreadsheets (MS Word, Excel, Access, PDF, Outlook, etc.).
Experience navigating multiple Electronic Medical Records (EMRs).
Reliable high-speed, secure home internet connection (minimum 50 Mbps download, 10 Mbps upload), a private home office with a locking door, and backup internet options.
What We Offer:
Competitive Salary: $70,000 per year, paid bi-weekly.
Flexible Scheduling: Flexible daytime scheduling is available, including four 10-hour shifts, Monday through Friday between the hours of 6am and 6pm CT. This flexibility can be requested after a successful orientation and evaluation by an immediate supervisor.
Fully Remote Work: Enjoy the flexibility of working from home.
Comprehensive Benefits:
Medical, dental, and vision insurance.
401(k) plan with a 3% employer match on your 6% contribution.
Life and disability insurance, with voluntary life options.
Employee Assistance Program (EAP).
Flexible Time Off.
Paid parental leave.
Learning and development opportunities.
Commitment to Equal Opportunity Employment: We are dedicated to diversity, inclusion, and belonging, and are an equal opportunity employer.
Technology Provided: We provide the necessary equipment for your remote work.
Remote Work Technical Requirements:
Reliable high-speed internet connection (minimum 50 Mbps download, 10 Mbps upload).
We encourage you to apply if you're a passionate and qua
Employment Type: Full-Time
Salary: $ 82,734.00 Per Year
Job Tags
Full time, Immediate start, Remote job, Home office, Flexible hours, Shift work, Weekend work, Monday to Friday,