Case Management Coordinator – Field

• Evaluate members’ needs and eligibility using care management tools, information, and data review
• Recommend approaches to case resolution and meeting member needs by evaluating benefit plans and available programs and services
• Identify high-risk factors and service needs and refer members to clinical case management or crisis intervention when appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome care barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalation quality-of-care issues through established channels
• Negotiate appropriate options and services to meet members’ benefits and healthcare needs
• Use influencing and motivational interviewing skills to engage members and promote lifestyle and behavior changes
• Coach, inform, and support members in making independent medical and healthy lifestyle choices
• Help members participate knowledgeably with providers in healthcare decision-making
• Participate in team meetings and provide peer mentoring/training
• Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements

• Must live near Winnebago County
• 2 years of experience in behavioral health, social services, or an appropriate related field equivalent to the program focus
• Confidence working at home and independently while using tools to collaborate virtually with teams
• Reliable transportation and willingness and ability to travel up to 75% of the time in and around Winnebago County
• Excellent analytical and problem-solving skills
• Effective communication, organizational, and interpersonal skills
• Ability to work independently
• Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications
• Efficient computer skills, including navigating multiple systems and keyboarding
• Bachelor’s degree or non-licensed master level clinician required, in behavioral health or human services such as psychology, social work, marriage and family therapy, or counseling
• Case management and discharge planning experience preferred
• Managed Care experience preferred

Demonstrates expertise in case management and quality management processes, with a strong focus on behavioral health and social services. Proficient in engaging members through motivational interviewing and effective communication to promote healthy lifestyle choices and navigate healthcare decision-making.

• Case Management Experience
• Behavioral Health Expertise
• Motivational Interviewing Skills
• Analytical Problem-Solving Skills
• Managed Care Experience

• Case Management
• Discharge Planning
• Behavioral Health
• Data Review
• Quality Management Processes
• Benefit Plan Evaluation
• Crisis Intervention
• Healthcare Decision-Making
• Analytical Skills
• Organizational Skills

• Effective Communication
• Interpersonal Skills
• Coaching Skills
• Team Collaboration
• Independent Work

• Bachelor’s Degree in Behavioral Health
• Master Level Clinician (Non-Licensed)

• Social Services
• Healthcare
• Managed Care
• Quality of Care
• Accreditation Compliance

• MS Word
• MS Excel
• MS Outlook
• MS Power Point
• Proprietary Applications