Illinois Licensed Clinical Care Manager

Job Summary

A company is looking for a Clinical Care Manager who is passionate about advancing high-quality, compliant, patient-centered care.

Key Responsibilities

• Conduct timely reviews of healthcare services to support clinical determinations
• Collaborate with medical professionals for evaluations of medical necessity and treatment appropriateness
• Manage care coordination and support eligible members through disease management programs

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in Illinois
• 5+ years of experience in varied healthcare settings
• Knowledge of utilization review and managed care processes
• Meets Illinois CE requirement of 20 hours per 2-year RN license renewal cycle
• Strong proficiency in Microsoft 365 applications