Case Management Coordinator

Our Client, a Retail Pharmacy company, is looking for a Case Management Coordinator for their Southside / Westside of Boone / McHenry Counties, IL location.

Responsibilities :

• 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.
• 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.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements :

Why Should You Apply?

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.