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Nurse Case Manager II

  • Illinois, Downers Grove

  • 02/11/2026

  • Contract

  • Active

Job Description:

  • Job Summary  
    The Nurse Case Manager II is responsible for telephonic and/or face-to-face assessments, planning, implementing, and coordinating care management activities to ensure members’ medical and behavioral health needs are met. This role enhances overall wellness by developing proactive care plans, facilitating short- and long-term outcomes, and integrating available resources. The Nurse Case Manager applies advanced clinical judgment to reduce risk factors, address complex health and social indicators, and support members through crisis intervention and care transitions.

    Key Responsibilities
    1. Conduct comprehensive assessments of members’ needs using clinical tools and data review.
    2. Develop and implement individualized care plans aligned with benefit plans and available programs.
    3. Apply clinical judgment to address risk factors and complex health/social indicators.
    4. Perform crisis intervention and provide follow-up to ensure appropriate treatment and services.
    5. Serve as a single point of contact for members, addressing immediate gaps in care and access.
    6. Collaborate with managers, medical directors, and interdisciplinary care teams to overcome barriers.
    7. Present cases at conferences/rounds to achieve optimal outcomes.
    8. Identify and escalate quality of care issues through established channels.
    9. Utilize motivational interviewing to maximize member engagement and support lifestyle changes.
    10. Empower members to participate actively in healthcare decision-making.
    11. Monitor and adjust care plans in collaboration with members and providers.
    12. Facilitate transitions of care and clinical hand-offs.
    13. Ensure compliance with regulatory and company policies in care management processes.

    Required Qualifications
    1. Associate Degree or Diploma in Nursing required.
    2. Current, unrestricted RN license in the State of Illinois.
    3. Minimum of 3–5 years of clinical practice experience in hospital or alternative care settings (ambulatory care, outpatient clinic, etc.).
    4. At least 2 years of experience using personal computers, navigating multiple systems, and proficiency in MS Office Suite (Teams, Outlook, Word, Excel).
    5. Strong clinical assessment, communication, and care coordination skills.

    Preferred Qualifications (if any)
    1. Bachelor of Science in Nursing (BSN).
    2. Case management experience in an integrated model.
    3. Managed care or discharge planning experience.
    4. Experience providing care to Medicaid populations.
    5. Spanish-speaking ability.

    Certifications (if any)
    1. RN license with current unrestricted Illinois state licensure – required.
    2. Case Management Certification (CCM or ACM) – preferred.

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