Remote Clinical Case Manager - LCSW (Social Worker)

Current IL LCSW, LCPC, or LPC license. Minimum of five years of experience in a variety of health care settings or Managed Care Organization. Basic knowledge of case management principles, healthcare management, and reimbursement components. Experience in motivational interviewing. Excellent clinical judgment. Highly skilled in verbal and written communication. Strong organizational, problem-solving, and time management skills. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Ability to work independently and remotely with multi-tasking skills. Software knowledge including word processing and spreadsheets (MS Word, Excel, Access, PDF, Outlook). Experience navigating multiple EMR's. High speed/secured home internet connection, a home office with a door that locks, and back-up connection service options.

Pull, sort, and analyze data to determine member eligibility for the Population Health management Program. Coordinate and provide timely, effective, equitable, safe, and member-centric care following HMO processes. Manage case assignments including outreach, documentation, monitoring, and closure. Meet reporting and documentation standards. Assist members in reaching wellness and health-autonomy by addressing barriers and psychosocial issues. Educate members on navigating the HMO and healthcare spectrum. Support operational aspects of the division. Maintain confidentiality of computer programs, medical records, and data. Participate in QM/UM Committee Meetings if applicable. Rotate in off-hour/weekend calls if applicable. Engage in continued professional growth and education.