RN Care Manager (Telephonic, Illinois)

Quick Facts

• Role: RN Care Manager (Case Management)
• Focus: Medicare member care management and coordination
• Work style: Primarily telephonic with occasional in-person/at-home visits
• Schedule: Monday–Friday, 8 AM–5 PM CST (work from home)
• Travel: Estimated 25–40% local travel as required

Description

Provides care management/care coordination support and collaborates with a multidisciplinary team to coordinate integrated delivery of member care across the continuum. Conducts comprehensive assessments to determine eligibility for care management and develops care coordination plans in collaboration with members and providers. Monitors care plan effectiveness, documents interventions and outcomes, and helps integrate behavioral health, LTSS, and community resources.

Responsibilities

• Complete comprehensive member assessments within regulated timelines
• Determine care management eligibility using clinical judgment and assessment triggers
• Develop and implement care coordination plans with members, caregivers, physicians, and other professionals
• Conduct telephonic, face-to-face, or home visits as required
• Monitor care plans, evaluate effectiveness, document interventions, and recommend changes
• Maintain an ongoing member caseload for regular outreach
• Promote integration of behavioral health, LTSS, and home/community resources
• Facilitate interdisciplinary care team (ICT) meetings and informal collaboration
• Use motivational interviewing and clinical guideposts to educate, support, and motivate change
• Assess barriers to care and provide coordination and assistance to address concerns
• Provide consultation, resources, and recommendations to peers as needed
• Manage complex member cases and medication regimens when assigned; may perform medication reconciliation
• Travel locally 25–40% as needed by state/contract requirements

Requirements

• Active, unrestricted RN license in the state of practice
• 2+ years of healthcare experience, preferably in care management or a medical/behavioral health setting (or equivalent)
• Valid and unrestricted driver’s license, reliable transportation, and adequate auto insurance for job travel
• Understanding of EMR systems and HIPAA
• Demonstrated knowledge of community resources
• Proactive, detail-oriented work style
• Ability to work independently with minimal supervision and self-motivation
• Responsive communication and ability to remain calm in high-pressure situations
• Ability to develop and maintain professional relationships
• Excellent time-management and prioritization; ability to manage multiple projects and adapt to change
• Strong verbal and written communication plus critical-thinking/problem-solving skills
• Proficiency with Microsoft Office suite and ability to navigate online portals and databases

Benefits

• Competitive benefits and compensation package
• Pay range: $27.73–$54.06 per hour (actual compensation may vary by location, experience, education, and/or skills)