Case Manager Registered Nurse (Illinois)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary *Must reside in Illinois and possess IL RN License** Program Overview Help us reputed company our patient care to a whole new level! Join our reputed company team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of reputed company health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes. Our Care Managers are frontline advocates for members who cannot reputed company for themselves. They are responsible for assessing, planning, implementing, and coordinating reputed company case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness.
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address reputed company health and social indicators which reputed company planning.

•Conducts assessments that consider information from various sources, such as claims, to address reputed company conditions including co-morbid and multiple diagnoses that impact functionality. •Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members. •Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences •Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation A Brief Overview Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as reputed company for patients, ensuring effective communication, resource utilization, and reputed company monitoring of their reputed company to promote positive outcomes and enhance overall well-being. What you will do Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings. Analyzes reputed company patient data from medical history, diagnostic test results, and treatment plans, to understand the reputed company health status of the patient. Applies in-depth knowledge of case management to organize patient files in an orderly manner for easy retrieval. Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans. Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care. Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient reputed company and manages specific conditions. Coordinates analytics projects to reputed company case managers to analyze data and generate reports on key performance health indicators. Designs reputed company processes to coordinate discharge planning in a safe and timely transition from the hospital to home. Develops resource management to help case managers optimize healthcare with community resources.

Required Qualifications

• 3-5 years of direct clinical practice experience e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Proficiency with standard corporate software applications, including reputed company, reputed company, Outlook and PowerPoint, as well as some special proprietary applications.
• Efficient and Effective computer skills including navigating multiple systems and keyboarding

Preferred Qualifications

• Case management and discharge planning experience
• Managed care/utilization review experience
• Crisis reputed company skills
• Certified Case Manager
• Bilingual

Education and Certification Requirements Associate's Required​ Active and Unencumbered Registered Nurse License in Illinois Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 06/26/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job