Government Programs Care Manager III
New
H
HCSCHealthcare care management
This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and HawaiiFull-TimeManager
Salary30.45 - 54.98 USD per year
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Job Details
- Languages
- Bilingual in English and Spanish (preferred).
- Experience
- 2 years direct clinical care or clinical practice experience; plus 3 years’ wellness or managed care experience presenting clinical issues with members/physicians.
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Hold an eligible professional qualification and license: Registered Nurse (RN) with 2 years of direct clinical care, or one of the listed state-specific counseling, social work, or marriage and family therapy licenses with 2 years of clinical practice experience.
- Maintain a current, valid, unrestricted license in the state of operations or reciprocity.
- For compact licensees changing permanent residence to the state of operations, obtain active, unrestricted RN licensure in that state within 90 days of hire.
- Have 3 years of wellness or managed care experience presenting clinical issues with members or physicians.
- Demonstrate knowledge of the health and wellness marketplace and employer trends.
- Have verbal and written communication skills for discussing medical needs with members and interfacing with staff, management, vendors, and community resources.
- Have analytical experience, including medical data analysis.
- Be proficient with Word, Excel, and PowerPoint, and have database and web-based application experience.
- Hold a current unrestricted driver’s license and have transportation and applicable insurance.
- Be able and willing to travel within the assigned territory.
- For Illinois high-needs children work, meet the stated bachelor’s degree and supervised clinical experience requirements.
- Preferred qualifications include 3 years of direct clinical experience, patient education, condition management, complex or catastrophic case management, and case management or other listed certification.
Responsibilities
- Coordinate care for members through telephonic and field-based care management.
- Inform and educate members about health care programs addressing their personal health needs.
- Engage members in discussions about adherence to personal health goals.
- Respond to member inquiries.
- Complete member telephonic and field-based health screenings and comprehensive health assessments.
- Develop care plans for complex and specialty populations.
- Visit members’ homes and facilities when needed to support care management.
- Support clinical operations with provider and member activities.
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