Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

Education/Experience: Requires a Bachelor's degree and year of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Physically Disabled/Elderly Candidate must meet one of the following criteria: . RN licensed in Illinois. . Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology. . LPN with one () year experience in conducting comprehensive assessments and provision of formal service for the elderly

In addition to meeting one of the above criteria, must have experience working with: • Addictive and dysfunctional family systems • Racial and ethnic minorities • Homosexuals and bisexuals • Persons with AIDS, and • Substance abusers .Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome

Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care

Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members

Provides resource support to members and their families/caregivers for various needs ( employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans

Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs

Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met

Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate

Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits

Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner Performs other duties as assigned

Complies with all policies and standards Story Behind the Need – Business Group & Key Projects Health plan or business unit Team culture Surrounding team & key projects Purpose of this team Reason for the request Motivators for this need Any additional upcoming hiring needs? openings, team makes contractual contact with our members to assess for any unmet needs, services and addresses any barriers to health. Mainly telephonic assessments, calls to members or parents, providers. Typical Day in the Role Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description Full time, may need to work sometimes past pm as older members or parents are home after pm, but can flex during day for this. Remote position, but we do meet in office every - months for meetings and team engagement activities. New hires may need to go to office for initial training. Compelling Story & Candidate Value Proposition What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained This role is interesting because you get to connect with our members or parents of children with special health care needs and challenges and assist them. Team is highly engaged and supportive of each other, always willing to help each other. This is a fast-paced position, must be a very quick learner and receptive to feedback. Candidate Requirements Education/Certification Required: HS Diploma Preferred: Bachelor Licensure Required: n/a Preferred: n/a Years of experience required Disqualifiers Best vs. average Performance indicators Must haves: excellent customer service skills, strong computer skills, attention to detail, telephonic work, reliable internet connection

Nice to haves: bilingual

Disqualifiers: no experience working with Medicaid and special health care needs

Performance indicators: no metrics, candidates need to have good work ethic/time management/organization. There is a productivity log, but the tasks are very fluid.

Best vs. average: quick learner, engaged, asks valid questions, cares about quality of work, takes initiative, cares for members’ needs. Top must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection Computer skills – high level of exp, important (Microsoft Office) Communication skills – high level of exp, will be on telephonic majority of time Decision-making skills – be able gather information via probing to make decisions Candidate Review & Selection Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations Projected HM Candidate Review Date: - days post-shortlisting Number and Type of Interviews: , Teams, Camera On Required Testing or Assessment (by Vendor): n/a Manager Communication Preferences & Next Steps Background Check Requirements (List DFPS or other specialty checks here) n/a Do you have any upcoming PTO? n/a Colleagues to cc/delegate n/a