Job Description
Job Overview:
We are seeking an experienced and compassionate Licensed Clinical Social Worker (LCSW), Licensed Clinical Professional Counselor (LCPC), or Licensed Professional Counselor (LPC) in Illinois to join our team as a Clinical Case Manager. In this role, you will play a critical part in supporting members through their healthcare journey, helping them navigate the system, achieve personal health goals, and maximize overall wellness. You will work closely with clients and members, providing telephonic outreach, conducting assessments, and ensuring high-quality, cost-effective care.
As part of the Value-Based Care Services team, you will contribute to data analysis, clinical reviews, reporting, and care coordination while maintaining compliance with Federal and State regulations, NCQA standards, and company policies.
Key Responsibilities:
Analyze and organize data to determine member eligibility for the Population Health Management Program.
Coordinate and deliver timely, effective, equitable, and member-centered care following HMO processes.
Manage case assignments, including outreach, documentation, case monitoring, and closure.
Maintain accurate records and meet reporting/documentation standards while actively participating in team meetings.
Assist members in overcoming barriers to care by addressing social determinants, psychosocial challenges, and individual motivators.
Educate members on navigating the healthcare system, including HMO processes, to ensure informed decision-making and cost-effective outcomes.
Support operational needs to maintain high customer satisfaction.
Ensure strict confidentiality regarding medical records, data, and all electronic systems.
Participate in Quality Management and Utilization Management Committee meetings, including material preparation, data collection, analysis, and follow-up tasks (may require occasional in-person attendance).
Provide support in off-hours or weekend rotations as needed.
Engage in ongoing professional development to stay current with case management standards and licensing requirements.
Adapt to program changes and additional responsibilities as assigned.
Qualifications:
Active and unrestricted Illinois licensure as an LCSW, LCPC, or LPC.
Minimum of five years of experience in healthcare settings or a Managed Care Organization.
Strong understanding of case management principles, healthcare management, and reimbursement structures.
Experience with motivational interviewing techniques.
Excellent clinical judgment and highly developed verbal and written communication skills.
Strong organizational, problem-solving, and time-management skills.
Ability to work independently in a fast-paced remote environment.
Proficiency in Microsoft Office Suite (Word, Excel, Access, Outlook, PDF) and experience navigating multiple Electronic Medical Records (EMRs).
Secure home office with high-speed internet (minimum 50 Mbps download, 10 Mbps upload) and backup connectivity options.
Compensation & Schedule:
Salary: $70,000 per year.
Schedule: Flexible daytime scheduling available (e.g., four 10-hour shifts), Monday through Friday, between 6:00 AM and 6:00 PM CT. Flexibility is available after a successful orientation and supervisor evaluation.
Benefits:
We prioritize your well-being and career growth. Our comprehensive benefits package includes:
Remote Work Flexibility: Enjoy a fully remote position with no commuting required.
Health Coverage: Comprehensive medical, dental, and vision plans.
Retirement Savings: 401(k) with a 3% employer match on a 6% employee contribution.
Life & Disability Insurance: Employer-provided coverage plus voluntary life insurance options.
Employee Assistance Program (EAP): Confidential support during challenging times.
Flexible Time Off (FTO): Encourages work-life balance tailored to your needs.
Parental Leave: Paid time off to support growing families.
Professional Development: Resources and opportunities to advance your career.
Commitment to Diversity & Inclusion:
We are an equal opportunity employer and are committed to fostering an inclusive workplace where diversity is celebrated. Employment decisions are made without regard to race, religion, gender identity, age, national origin, disability, veteran status, or any other protected category. We uphold fair hiring, placement, promotion, compensation, and employment practices.
Remote Work & Security Requirements:
This is a fully remote position. Employees must provide their own high-speed internet connection capable of supporting video calls and secure system access. All work must be performed in a private home office environment with a door that locks to maintain confidentiality. Security policies and HIPAA regulations must be strictly followed to protect patient and company data.
Employment Type: Full-Time
Salary: $ 82,701.00 Per Year
Job Tags
Full time, Remote job, Work from home, Home office, Flexible hours, Shift work, Weekend work, Monday to Friday,