Care Management Specialist II | Remote | Illinois | Contract to Hire

Care Management Specialist II | 2+ Years of Experience | Remote | Illinois | Contract to Hire Walker Healthforce is seeking a Care Management Specialist II with 2+ years to support a healthcare payor client remotely based out of Illinois. This is a 6-month contract to hire opportunity. PAY RATE: $39 - $41 START DATE: ASAP HOURS/SCHEDULE: M-F; 8:00 AM - 5:00 PM CST WORKER TYPE: Full-Time W2 CORE REQUIREMENTS:

• Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with an active, unrestricted license in the state of operations (or reciprocity, if applicable).
• Required licensure credentials include LCPC, RN, LCSW.:
• Minimum 2 years of clinical experience.
• At least 1 year of experience in health insurance or managed care.
• Understanding of medical management policies and procedures.
• Proficiency in PC and database systems and customer service orientation and ability to interact professionally with healthcare providers and members.
• Occasional travel within the assigned area.
• Valid driver’s license and reliable transportation.

JOB RESPONSIBILITIES:

• Coordinate discharge, episodic case management, and pre-admission/post-discharge counseling.
• Identify alternate treatment options.
• Consult with physicians, coordinators, and discharge planners to determine appropriate care and resources.
• Educate and counsel members to minimize re-admissions and emergency room visits.
• Perform multiple functions to assist members during transitions of care, including:
• Consult with providers, members, and others to assess and implement care plans.
• Personalize outreach based on behavior and risk assessment.
• Support medication reconciliation, education, and adherence.
• Reinforce post-operative instructions (care, diet, activity).
• Address barriers to follow-up appointments and help with scheduling.
• Assist with locating providers, Blue Distinction Centers, and coordinating with Customer Service.
• Help members access care, including transportation support if necessary.
• Refer members to internal BCC programs or external community-based resources.
• Provide on-site, face-to-face interventions for selected cases.
• Educate members on condition management and promote self-care.
• Collaborate on alternative care plans if needed.
• Help members/providers navigate the healthcare system.
• Identify and refer quality of care issues to the QA/QI department.
• Deliver Transition of Care services across all assigned lines of business.
• Assess and escalate complex cases to appropriate departments (Case Management, Disease Management, etc.).
• Practice within the scope of licensure.
• Serve as a preceptor for new employee orientation.
• Maintain licensure and enhance professional knowledge through training and seminars.
• Communicate effectively and professionally with colleagues, management, and customers.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other company policies.
• Maintain strict confidentiality of company and member information.
• Report developments to management and perform special projects as assigned.

WHAT WE OFFER:

• Competitive compensation package
• Weekly pay via Direct Deposit
• Medical, Dental & Vision available
• 401k options

WHY WORK WITH WALKER?

• Access to our top ranked team of recruiting and placement specialists
• Continuous, one-on-one support from a dedicated engagement manager
• Professional resume development and interview preparation

Contact our Recruiting Team today to experience the Walker Healthforce difference! ABOUT US: Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today! We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. #IND1 Apply Job! Apply to this Job