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    Case Manager I - Springfield, United States - Professional Management Enterprises

    Professional Management Enterprises
    Professional Management Enterprises Springfield, United States

    3 days ago

    Default job background
    Description

    Seeking RN, LSW, LCSW, LPC or LCPC with LTSS experience to be responsible for health care management and coordination of members to achieve optimal clinical, financial and quality of life outcomes.

    MUST reside in the
    Springfield, IL area. Schedule M-F 8:00am-5:00pm.


    Day to Day Responsibilities:Will be responsible for performing case management activities according to the contractual requirements and in alignment with NCQA requirements. Manage a caseload of approximately 130 LTC (Long Term Care) cases. Complete face-to-face visits with members in the LTC facilities at a minimum of an annual visit per member. Complete an annual assessment, assessment summary (DAR), care plan, and service plan per member. Collaborate with the LTC provider staff. Participates as needed in clinical care rounds.


    Must Have Skills:

    • Must have a valid driver's license and reliable vehicle for field visits
    • Excellent communication skills, with an ability to communicate effectively with members with chronic conditions, developmental disabilities, etc.
    • Strong technical skills (utilizing multiple programs at the same time) along with competency in Microsoft applications (Outlook, Teams, Excel, etc.)
    • Strong organizational and interpersonal skills

    Required Years of Experience: Preferred RN/LSW/LCSW/LPC/LCPC background, but not required if enough experience in related field (about 5+ years). Previous case management or MCO experience is a plus.


    Required Licensure / Education:
    Bachelor's degree in nursing, social sciences, social work or related field or

    Bachelor or master's degree prepared in human-services related field
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