Position Summary
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires unrestricted driver's license and car.
Requires RN with unrestricted active license in IL
Duties
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Experience
Minimum 3-5 years clinical practical experience preferred
Minimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferred
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
Education
Requires a RN with unrestricted IL active license.
Experience with case management.
Case Management Certification CCM preferred
Field Based Case Managers: Caseloads typically range from 30 to 100 members, depending on market needs and complexity of member’s needs.
We want someone who is organized, efficient, and can work independently.
Notes:
Field Based Position
Position will require travel to members' homes up to 50-75% travel. Must live near areas listed due to travel requirement and will work at home in between visits.
8am to 5pm CST Mon-Fri
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
