RN Case Manager
W2 Contract
Pay Rate – $38/HR
Location: Downers Grove, IL
**Must reside in one of the following zip codes: 60608, 60609, 60615, 60616, 60619, 60620, 60621, 60629, 60632, 60636, 60637, 60652, or 60653
Summary
This position is responsible for conducting medical management and health education programs for members enrolled in government healthcare programs. The role involves gathering, analyzing, and reporting data for regulatory requirements while serving as a primary representative of the organization to members. The Care Manager works closely with members, physicians, community resources, and internal teams to support health and wellness initiatives and ensure quality care outcomes.
Responsibilities
- Conduct medical management and health education programs for government healthcare program members.
- Gather, analyze, and report data for regulatory and program reporting requirements.
- Assess and present clinical issues to members, physicians, and care teams.
- Coordinate care and wellness initiatives to support member health outcomes.
- Communicate effectively with members, providers, community organizations, and internal stakeholders.
- Maintain accurate documentation and reporting within applicable systems and databases.
- Travel throughout the assigned territory to support member needs and program objectives.
Required Qualifications
- One of the following:
- Registered Nurse (RN) with 3 years of direct clinical care experience in a clinical setting; OR
- Licensed Professional Counselor (LPC); OR
- Licensed Master Social Worker (LMSW) with the required clinical practice experience necessary to obtain licensure.
- Current, valid, and unrestricted license in the state of operation (or reciprocity).
- Compact license holders who establish permanent residency in the state of operation must obtain an active, unrestricted state license within 90 days of hire.
- 3 years of wellness or managed care experience presenting clinical issues to members and physicians.
- Knowledge of the health and wellness marketplace and employer healthcare trends.
- Strong verbal and written communication skills.
- Experience analyzing medical and healthcare-related data.
- Current driver's license, reliable transportation, and applicable insurance.
- Ability and willingness to travel within the assigned territory.
- Proficiency with Microsoft Office applications, including Word, Excel, and PowerPoint, as well as database and web-based systems.
Preferred Qualifications
- 3 or more years of clinical experience.
- Patient education experience.
- Condition Management experience.
- Bilingual in English and Spanish.
- Transition of Care experience.
- Experience managing complex or catastrophic cases.
- Certification in Case Management, Training, Project Management, or another nationally recognized healthcare certification.
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