Clinical Case Manager - LCSW (Social Worker) - Remote | WFH

Are you a licensed mental health professional in Illinois looking for a meaningful remote opportunity? We are seeking an experienced and compassionate Clinical Case Manager to support individuals in navigating the healthcare system, enhancing care quality, and improving health outcomes. If you are passionate about helping people achieve their personal wellness goals, we'd love to hear from you!

About the Role

As a Clinical Case Manager, you will play a vital role in member care by conducting assessments, providing telephonic outreach, coordinating services, and ensuring high-quality, cost-effective care. You will work closely with members and healthcare teams to promote wellness, problem-solve challenges, and guide individuals toward greater health autonomy. This role is part of a Value-Based Care Services team and involves case management, data analysis, clinical review, and compliance with regulatory standards.

What You'll Be Doing

Analyze and organize data to determine member eligibility for the Population Health Management Program.

Provide member-centered care coordination while following HMO processes.

Manage case assignments, including outreach, documentation, progress monitoring, and case closure.

Maintain compliance with Federal/State regulations, NCQA standards, and organizational policies.

Assist members in overcoming barriers related to social determinants of health, motivators, and psychosocial challenges.

Educate members on navigating the HMO and healthcare system to support informed decision-making.

Participate in collaborative team meetings and reporting activities.

Maintain confidentiality and adhere to security protocols for medical records and data.

Attend Quality Management and Utilization Management Committee Meetings as needed.

Be available for rotation in off-hour/weekend calls, if applicable.

Engage in ongoing professional development and education in case management best practices.

What You'll Need to Have

Active Illinois license as an LCSW, LCPC, or LPC.

At least five years of experience in healthcare settings or managed care organizations.

Knowledge of case management principles, healthcare management, and reimbursement.

Experience in motivational interviewing and excellent clinical judgment.

Strong verbal and written communication skills.

Ability to work independently and manage multiple priorities in a fast-paced environment.

Proficiency in Microsoft Office (Word, Excel, Outlook, Access, PDFs, etc.).

Experience working with Electronic Medical Records (EMRs).

A secure home internet connection and a private home office space for confidentiality.

Availability for occasional on-site meetings in Rockford, IL, if required.

Compensation & Schedule

Salary: $70,000 per year

Schedule: Flexible daytime shifts available (including four 10-hour shifts), Monday through Friday, 6 AM - 6 PM CT. Flexibility can be requested after a successful orientation and supervisor evaluation.

Benefits We Offer

We are committed to supporting your well-being, professional growth, and work-life balance. Our benefits include:

100% Remote Work - Spend less time commuting and more time focusing on your goals.

Comprehensive Health Coverage - Medical, dental, and vision insurance.

401(k) Plan - Employer match of 3% to your 6% contribution.

Life & Disability Insurance - For added peace of mind.

Employee Assistance Program (EAP) - Support during challenging times.

Flexible Time Off - Achieve work-life balance.

Paid Parental Leave - For when your family grows.

Learning & Development - Opportunities for career advancement.

Commitment to Diversity & Inclusion

We believe in fostering an inclusive environment where everyone is valued. We are an equal opportunity employer and do not discriminate based on race, age, gender, sexual orientation, disability, veteran status, or any other legally protected status.

Remote Work Requirements

We provide necessary equipment at no cost.

You must have a reliable internet connection (minimum 50 Mbps download / 10 Mbps upload) to conduct video calls and access internal systems.

If you are looking for a meaningful remote role in case management and value-based care, apply today and make a difference in the lives of those who need it most!
Employment Type: Full-Time
Salary: $ 82,734.00 Per Year