Care Management Specialist II

Job Title : Care Management Specialist II

Pay Rate : $40-$42 / hr

Location : Fully remote (Illinois residents only) - onsite training required in Downers Grove, IL

Schedule : Monday-Friday, regular business hours

Licenses Accepted : LCPC, LCSW (preferred); RN with behavioral health experience accepted

Overview

Care Management Specialist II is responsible for post-acute care coordination, episodic case management, and pre- / post-discharge counseling . The role ensures smooth transitions of care, supports members after hospitalization, and helps prevent readmissions or ER visits.

This position requires strong clinical judgment, coordination with physicians and facilities, and the ability to work independently while supporting other staff as needed.

Key Responsibilities

Coordinate discharge planning, episodic case management, and transition-of-care services.

Consult with physicians, providers, and facility staff to determine appropriate post-discharge care and resources.

Provide education and counseling to members and families to promote understanding of care plans and reduce readmission risk.

Identify and address barriers to follow-up care (e.g., medication adherence, transportation, appointments).

Coordinate with internal departments (Case Management, Disease Management, etc.) when additional support is needed.

Perform outreach and follow-up calls to members post-discharge.

Reinforce provider instructions, monitor adherence, and provide resource information for ongoing care.

Participate in quality assurance activities and refer cases as needed for review.

Maintain confidentiality and compliance with HIP nd organizational policies.

Required Licensure :

LCPC, LCSW, or RN (must have behavioral health experience)

Active, unrestricted license in the state of Illinois

Experience :

Minimum 2 years clinical experience

Minimum 1 year in managed care or health insurance environment

Strong verbal / written communication and customer service skills

Proficiency with PC applications and databases

Reliable transportation and valid driver's license (minimal travel may be required)

Additional Details

Position is primarily remote but requires onsite training in Downers Grove, IL.

Rare travel within the region may occur depending on business needs.

Must maintain active licensure and participate in ongoing professional development.