Remote LCSW Clinical Case Manager (Social Worker) | Work From Home

Job Overview

We are in search of a dedicated and empathetic Clinical Case Manager (LCSW, LCPC, or LPC) licensed in Illinois to join our esteemed Value-Based Care Services team. This pivotal role involves assisting members in navigating the complexities of the healthcare system, improving their overall wellness, and achieving their individual healthcare objectives. Utilizing a collaborative, member-focused approach, you will significantly contribute to enhancing the quality of care, optimizing cost-effectiveness, and ensuring high levels of member satisfaction. This role is entirely remote, providing you with the flexibility to make a profound impact on the lives of individuals in need.

Key Responsibilities

• Evaluate data to ascertain member eligibility for the Population Health Management Program.
• Facilitate timely, effective, and equitable care coordination in alignment with HMO processes.
• Oversee case assignments, including outreach efforts, documentation, progress monitoring, and case closure.
• Ensure accurate and compliant reporting and documentation in line with Federal/State regulations and NCQA standards.
• Conduct telephonic outreach to engage members and providers for effective care coordination.
• Assist members in overcoming healthcare barriers by addressing social determinants, psychosocial factors, and personal motivators.
• Educate members on navigating the healthcare landscape, promoting informed decision-making and cost-effective interventions.
• Maintain confidentiality and adhere to all healthcare regulations, policies, and procedures.
• Participate in Quality Management and Utilization Management (QM/UM) Committee Meetings, including necessary preparation and follow-up tasks (which may require occasional in-person attendance).
• Be available for rotational off-hour/weekend calls, if applicable.
• Consistently pursue professional development to remain current on evolving case management standards.
• Carry out additional responsibilities as assigned based on evolving program requirements.
  
  

Required Skills

• Active Illinois licensure as an LCSW, LCPC, or LPC.
• At least five years of experience in healthcare settings, ideally including managed care organizations.
• Comprehensive understanding of case management principles, healthcare systems, and reimbursement structures.
• Proficient in motivational interviewing and evidence-based care coordination strategies.
• Exceptional clinical judgment, communication, and interpersonal skills.
• Strong organizational and problem-solving abilities with a knack for prioritizing and managing tasks effectively.
• Capable of working independently in a remote environment while managing fast-paced workflows.
• Proficiency in Microsoft Office Suite (Word, Excel, Access, Outlook, PDF) and experience with multiple EMRs.
• A secure high-speed internet connection and a dedicated home office with a locking door for privacy are required. Backup internet access may also be necessary.
  
  

Career Growth Opportunities

We are committed to fostering your professional development and offer various learning and advancement opportunities to help you grow within your career.

Compensation And Benefits

• Annual salary: $70,000.
• Flexible scheduling options, including four 10-hour shifts.
• Work hours available Monday through Friday, 6 AM - 6 PM CT (with flexibility post successful orientation and supervisor evaluation).
• Remote Work: Enjoy the convenience of a fully remote setup.
• Comprehensive Health Coverage: Medical, dental, and vision insurance to support your overall well-being.
• Retirement Planning: 401(k) plan with a 3% employer match to secure your financial future.
• Life & Disability Insurance: Coverage options for peace of mind, including voluntary life insurance.
• Employee Assistance Program (EAP): Resources providing personal and professional support.
• Flexible Time Off: Encouragement to take time as needed to maintain a healthy work-life balance.
• Parental Leave: Paid leave to support growing families.
  
  

If you are passionate about guiding individuals on their healthcare journeys and excel in a remote, collaborative environment, we urge you to apply! This role presents an exceptional opportunity to make a lasting impact while enjoying the benefits of a supportive and flexible work environment.

Employment Type: Full-Time