Government Programs Care Manager III - 743 - Work From Home
About The Position
This position provides care coordination to members through telephonic and/or field-based care management. The Care Manager informs and educates members about health care programs addressing their personal health needs, engages them in discussion about adherence to personal health goals, responds to member inquiries, and supports clinical operations through provider and member activities. Duties include conducting telephonic and/or field-based health screenings, comprehensive health assessments, and care planning for complex and specialty populations. The work may require visits to members’ homes and/or facilities. Field-based care covers the Northwest and South Chicagoland area. The role may be performed remotely from anywhere in the continental United States, excluding California, New York, Alaska, and Hawaii. This is a union role. Sponsorship is not available.
Requirements
- Registered Nurse (RN) with 2 years of direct clinical care to consumers in a clinical setting; or Licensed Clinical Professional Counselor (LCPC, Illinois), Licensed Clinical Social Worker (LCSW, Illinois and New Mexico), or Licensed Marriage and Family Therapist (LMFT, Illinois and New Mexico) with 2 years of clinical practice experience.
- Current, valid, unrestricted license in the state of operations or reciprocity. A compact-license holder changing permanent residence to the state of operations must obtain active, unrestricted RN licensure in that state within 90 days of hire.
- 3 years of wellness or managed care experience presenting clinical issues to members and 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 and management, external vendors, and community resources.
- Analytical experience, including medical data analysis.
- PC proficiency with Word, Excel, and PowerPoint, as well as database experience and web-based applications.
- Current unrestricted driver’s license, transportation, and applicable insurance.
- Ability and willingness to travel within the assigned territory.
Nice To Haves
- 3 years of direct clinical experience.
- Patient education experience.
- Condition Management experience.
- Bilingual in English and Spanish.
- Experience managing complex or catastrophic cases.
- Certification in Case Management, Training, Project Management, or a nationally recognized health care certification.
- Government Programs experience.
- Population Management.
Responsibilities
- Provide care coordination through telephonic and/or field-based care management.
- Inform and educate members about health care programs that address their personal health needs.
- Engage members in discussions about adherence to personal health goals and respond to member inquiries.
- Support clinical operations with provider and member activities.
- Complete member health screenings, comprehensive health assessments, and care planning, including for complex and specialty populations.
- Visit members’ homes and/or facilities when needed.
- Travel within the assigned territory.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
