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Nurse Case Management Senior Analyst (IL)
Ref No.: 20-01872
Location: Chicago, Illinois
Duties:
  • Obtains informed verbal consent and takes all steps to obtain written consent as appropriate.
  • Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for optimal outcomes.
  • Promote consumerism through education and health advocacy.
  • Assesses member's health status and treatment plan and identifies any gaps or barriers to healthcare.
  • Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
  • Implements, coordinates, monitor and evaluate the case management plan on an ongoing, appropriate basis.
  • Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures
  • Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
  • Demonstrates sensitivity to culturally diverse situations, clients and customers.
Skills:
  • Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills
  • Strong personal computer skills, MS word, Excel, Outlook experience, and Internet research desired
  • Strong skills in the following areas: teamwork, conflict management, assessment complex issues, ability to recommend changes and resolve problems through effective decision making
  • Experience in medical management and case management in a managed care setting is highly desirable
  • Knowledge of managed care products and strategies
  • Demonstrated sensitivity to culturally diverse situations, participants and customers
Education:
  • Active unrestricted Registered Nurse (RN) license in state or territory of the United States
  • Two years full-time equivalent of direct clinical care to the consumer
  • CCM Certification preferred
Languages:
  • English Read Write Speak