Field Case Management Analyst

Summary

ICONMA is seeking a Field Case Management Analyst for a retail pharmacy client's Long Term Services & Supports team. The role evaluates members' needs and eligibility, coordinates care plans, supports healthcare decision-making, and facilitates appropriate outcomes for waiver/LTSS members in the Chicago area.

Responsibilities

• Reliable Transportation required, eligible for mileage reimbursement as per company policy
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience
• **Evaluation of Members:**
• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members' needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members' benefit plan and available internal aid 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
• **Enhancement of Medical Appropriateness and Quality of Care:**
• 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 knowledgeably participate with their provider in healthcare decision-making
• **Monitoring, Evaluation and Documentation of Care:**
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
• This Analyst, Case Management Field position is with Client Long Term Services & Supports (LTSS) team and is a field-based position out of the west side of Chicago area of Illinois
• Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources

Skills

• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience
• Individual with a bachelor's degree or a non-licensed individual with a master's degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)
• Verifyable High School Diploma or GED Required

Qualifications

Must Haves

• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience
• Individual with a bachelor's degree or a non-licensed individual with a master's degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)
• Verifyable High School Diploma or GED Required

Benefits

• Eligible for mileage reimbursement as per company policy
• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities