Job Description
We are seeking a dedicated 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 enhance the quality of member care, promote wellness, and assist individuals in navigating the healthcare system. As a key member of the Value-Based Care Services team, you will engage with members and providers to support their healthcare goals through education, problem-solving, and care coordination.
What You'll Be Doing
Analyze and assess data to determine member eligibility for the Population Health Management Program.
Coordinate and provide timely, effective, and member-centric care while following HMO guidelines.
Manage case assignments, including outreach, documentation, case monitoring, and closure.
Maintain compliance with federal and state regulations, NCQA standards, and company policies.
Assist members in achieving health autonomy by addressing barriers, social determinants, motivators, and psychosocial concerns.
Educate members on navigating the healthcare system while promoting cost-effective and quality care.
Support operational aspects of the division to enhance customer satisfaction.
Ensure the confidentiality of all medical records and program data.
Participate in Quality Management and Utilization Management (QM/UM) Committee Meetings, which may require in-person attendance.
Engage in a rotation of off-hour/weekend calls, if applicable.
Stay up to date on case management standards and licensing requirements through continued professional development.
What You'll Need to Have
Active Illinois LCSW, LCPC, or LPC license.
Minimum of five years of experience in various healthcare settings or managed care organizations.
Knowledge of case management principles, healthcare management, and reimbursement models.
Experience with motivational interviewing and member engagement strategies.
Strong clinical judgment and excellent verbal and written communication skills.
Exceptional organizational, problem-solving, and time management abilities.
Ability to multitask and adapt in a fast-paced, evolving environment.
Proficiency in Microsoft Office Suite (Word, Excel, Access, Outlook, PDF, etc.).
Experience working with Electronic Medical Records (EMR) systems.
Reliable high-speed internet and a secure home office with a door that locks for privacy.
A backup internet connection solution, such as the ability to travel to a Rockford, IL office on short notice (if required).
Compensation & Scheduling
Annual Salary: $70,000
Flexible scheduling options: Choose from standard Monday-Friday hours (6 AM-6 PM CT) or four 10-hour shifts per week (subject to supervisor approval after orientation).
Benefits & Perks
Fully remote work environment—spend less time commuting and more time focusing on your professional and personal goals.
Comprehensive health benefits, including Medical, Dental, and Vision plans.
401(k) plan with a 3% employer match.
Life and Disability insurance, with additional voluntary Life options available.
Employee Assistance Program (EAP) to support you through personal and professional challenges.
Flexible Time Off (FTO) to help you maintain a work-life balance.
Paid Parental Leave for growing families.
Career growth and development opportunities to support your professional journey.
Our Commitment to Diversity & Inclusion
We are an equal opportunity employer, dedicated to fostering an inclusive and diverse workplace. Employment decisions are made without regard to race, gender, age, religion, sexual orientation, disability, veteran status, or any other protected status. Our goal is to create an environment where everyone feels valued and supported.
Remote Work Requirements
Company-provided equipment for your role at no cost.
Reliable home internet connection (minimum 50 Mbps download / 10 Mbps upload speed).
Ability to conduct video calls on camera and connect to various internal and external systems.
Secure home office setup that ensures confidentiality and privacy.
If you're passionate about improving healthcare access and supporting individuals in their wellness journey, we'd love to hear from you!
Employment Type: Full-Time
Salary: $ 82,320.00 Per Year
Job Tags
Full time, Remote job, Home office, Flexible hours, Shift work, Weekend work, Monday to Friday,