Clinical Case Manager II – Hybrid-167888

Job Title: Clinical Case Manager II (ICM CCM) – Hybrid-167888 Location: Illinois (Candidates may reside anywhere in Illinois; hybrid role with occasional local member visits as needed) Pay: $35.87 per hour Schedule: Monday – Friday | 8:00 AM – 5:00 PM CST Overview We are seeking a Clinical Case Manager II to join a leading healthcare organization supporting members enrolled in Medicare and Medicaid. This hybrid role allows candidates to work primarily from home while completing occasional in-person member visits in their local area as needed. As part of the Integrated Care Management (ICM) team, the Case Manager works with members who have complex health and social needs. Through collaboration, the Case Manager helps coordinate services and advocate for appropriate care to improve health outcomes and promote cost-effective care solutions. Key Responsibilities Conduct comprehensive assessments of members’ health, social, and care coordination needs. Develop and implement individualized case management plans based on member needs, benefit plans, and available resources. Collaborate with members, healthcare providers, and community organizations to coordinate services and support care plans. Apply clinical guidelines, policies, and regulatory standards to ensure appropriate benefit utilization and care management. Utilize clinical tools and data review to evaluate member eligibility and determine appropriate care strategies. Advocate for members by identifying resources and coordinating services to address medical and social determinants of health. Maintain accurate documentation while navigating multiple systems and case management platforms. Participate in care management and quality management processes in compliance with regulatory and accreditation standards. Caseload Information Telephonic/Hybrid Case Managers: Caseloads typically range from 250–500 members, depending on stratification and complexity of member needs. Field-Based Case Managers: Caseloads typically range from 30–100 members, depending on market needs and complexity.