Government Programs Care Manager III
New
H
HCSCHealthcare
This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.Full-TimeManager
SalaryUSD 30.45 - 54.98 / year; Base Pay Range $30.45 - $54.98
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Job Details
- Languages
- Bilingual in English and Spanish.
- Experience
- 2 years of direct clinical care in a clinical setting or 2 years of clinical practice experience; plus 3 years’ wellness or managed care experience presenting clinical issues with members/physicians.
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Hold an RN license with 2 years of direct clinical care to consumers in a clinical setting, 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 and 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 willing and able to travel within the assigned territory.
- Preferred: 3 years of direct clinical experience, patient education experience, and condition management experience.
- Preferred: experience managing complex or catastrophic cases, or in Government Programs or Population Management.
- Preferred: case management, training, project management, or nationally recognized healthcare certification.
- Preferred: experience working with children and young adults with behavioral health issues or similar conditions or behaviors in three of the last five years.
Responsibilities
- Provide telephonic and/or field-based care coordination to members.
- Inform and educate members about healthcare programs that address their personal health needs.
- Engage members in discussions about adherence to personal health goals.
- Respond to inquiries from members.
- Support clinical operations with provider and member activities.
- Complete member health screenings and comprehensive health assessments.
- Perform care planning for complex and specialty populations.
- Visit members’ homes and/or facilities as needed.
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