Senior LTSS Care Specialist openings with a major health insurance / managed care company based in the Chicago IL 60661 area! Starting ASAP!! Apply now with Luke H. at A-Line!

**Posting Location: Oak Park/Forest Park - Possible zip codes that candidate must reside in to qualify for this specific position: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60303, 60304, 60068, 60305, 60171, 60176, 60154, 60558**

Job Summary:

• Contact members approved for home and community-based services (HCBS) under the Aging, Disabilities, BI and/or HIV/AIDS waiver.
• Complete contractually required tasks as well as assist in coordinating overall health care.
• Document all interactions and required details within the system.

Pay Rate: $40 - $45 hourly (determined on experience)

Work Schedule:Monday - Friday 8am - 4:30pm

Describe the performance expectations/metrics:

• Passing all internal audits with a score of 90% or above (new employees receive 2 educational audits prior to having to meet that requirement)
• Meet weekly production expectations
• Complete all trainings (live sessions and modules) by required deadline
• Utilize time clocking system appropriately and adhering to attendance policy
• Compliance with all internal policies and procedures
• Follow up by required deadlines set forth by leadership

Required Experience:

• Bachelor's degree in human services related field; Including but not limited to (Child, Family and Community Services, Early Childhood Development, Guidance and Counseling, Home Economics, Human Development Counseling, Human Services Administration, Human Services, Health Administration, Master of Divinity, Pastoral Care/Counseling, Psychiatry, Nursing, Psychology, Public Admin, Social Science, Social Work, Sociology)
• Must have current state's RN, LCSW, LCPC, LSW, LPC licensure
• Must have some knowledge of healthcare and managed care experience (i.e., working in a hospital that worked HMO type of care)

Preferred Skills/ Experience:

• LTSS/HCBS waiver experience
• Care Coordination experience
• Home visit experience
• Remote/Work from home experience
• Plan of Care experience

Why Apply:

• Full benefits available after 90 days:Medical, Dental, Vision, Life, Short-term Disability
• 401k after 1 year of employment:With employer match and profit sharing
• GREAT Hours!Monday through Friday, 40 hours per week
• Competitive Pay Rate

Keywords: LTSS, Long Term Support Services, LCSW, LCPC, LSW, LPC, Concurrent Review, Retrospective Review, CCM, InterQual, ICD-10, URAC, CMS, Medicare, Medicaid, Case Management, Certified Case Manager, Medical Coding, BSN, Medical Management, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, HMO, Concurrent Review, Retrospective Review, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls.

Required Experience:

• Bachelor's degree in human services related field; Including but not limited to (Child, Family and Community Services, Early Childhood Development, Guidance and Counseling, Home Economics, Human Development Counseling, Human Services Administration, Human Services, Health Administration, Master of Divinity, Pastoral Care/Counseling, Psychiatry, Nursing, Psychology, Public Admin, Social Science, Social Work, Sociology)
• Must have current state's RN, LCSW, LCPC, LSW, LPC licensure
• Must have some knowledge of healthcare and managed care experience (i.e., working in a hospital that worked HMO type of care)

Preferred Skills/ Experience:

• LTSS/HCBS waiver experience
• Care Coordination experience
• Home visit experience
• Remote/Work from home experience
• Plan of Care experience

Why Apply:

• Full benefits available after 90 days:Medical, Dental, Vision, Life, Short-term Disability
• 401k after 1 year of employment:With employer match and profit sharing
• GREAT Hours!Monday through Friday, 40 hours per week
• Competitive Pay Rate

Keywords: LTSS, Long Term Support Services, LCSW, LCPC, LSW, LPC, Concurrent Review, Retrospective Review, CCM, InterQual, ICD-10, URAC, CMS, Medicare, Medicaid, Case Management, Certified Case Manager, Medical Coding, BSN, Medical Management, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, HMO, Concurrent Review, Retrospective Review, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls.