Remote Case Manager (Must live in either Whiteside or Henry Counties) - A-Line Staffing Solutions

Job Title: Remote Case Manager

Pay: $40.86 an hr | Bi-weekly

Job Type:

• Remote in Whiteside/Henry Counties or Winnebago County. Must live in Either county.

Shift Options:

• M-F 8-5 CST

Remote Case Manager Overview:

• Evaluation of Members:
  -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.
  
  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 knowledgably 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.