Government Programs Care Manager II – 743 – Work From Home
About The Position
This position is responsible for providing care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs. This includes engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations, provider, and member activities. The role requires completing member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning duties, which may involve visits to members’ homes and/or facilities. This is a Union Role and a Remote/Work-From-Home position.
Requirements
- Registered Nurse (RN), unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), Licensed Social Worker (LSW, IL) or Licensed Mental Health Counselor LMHC, NM).
- Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
- 3 years of wellness or managed care experience presenting clinical issues with members/physicians.
- Knowledge of the health and wellness marketplace and employer trends.
- Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
- Analytical experience including medical data analysis.
- PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
- Current unrestricted driver’s license, transportation and applicable insurance.
- Ability and willingness to travel within assigned territory.
- For Illinois Only: Bachelor’s degree in nursing, social sciences, social work, or related field and (1) year of supervised clinical experience in a human-services field.
Nice To Haves
- Direct clinical experience.
- Patient education experience.
- Condition Management experience.
- Bilingual in English and Spanish.
- Experience in managing complex or catastrophic cases.
- Certification in Case Management, Training, Project Management or nationally recognized health care certification.
- Government Programs experience.
Responsibilities
- Provide care coordination to members via telephonic and/or field-based care management.
- Inform and educate members on health care programs to address their personal health needs.
- Engage members in discussions about adherence to personal health goals.
- Respond to inquiries from members.
- Support clinical operations, provider, and member activities.
- Complete member telephonic and/or field-based health screenings.
- Conduct comprehensive health assessments.
- Perform care planning duties, which may require visits to members’ homes and/or facilities.
- Travel within assigned territory (Cook and Collar counties for Illinois).
Benefits
- Curated development plans that foster growth and promote rewarding, fulfilling careers.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
