Government Programs Care Manager III - 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 members in discussion of adherence to personal health goals, responds to member inquiries, and supports clinical operations with provider and member activities. The role includes member health screenings, comprehensive health assessments, and care planning, which may require visits to members’ homes and/or facilities to support complex and specialty populations. Field-based care is provided in the Rockford, Springfield, and Southern Illinois area. The role may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii. Sponsorship is not available.
Requirements
- Registered Nurse (RN) with at least 2 years of direct clinical care to consumers in a clinical setting; or an Illinois Licensed Clinical Professional Counselor (LCPC), an Illinois or New Mexico Licensed Clinical Social Worker (LCSW), or an Illinois or New Mexico Licensed Marriage and Family Therapist (LMFT), with at least 2 years of clinical practice experience.
- Current, valid, unrestricted license in the state of operations, or reciprocity. Compact licensees changing permanent residence to the state of operations must obtain active, unrestricted RN licensure in that state within 90 days of hire.
- At least 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, plus database and web-based application experience.
- Current unrestricted driver’s license, transportation, and applicable insurance.
- Ability and willingness to travel within the assigned territory.
Nice To Haves
- At least 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 telephonic and/or field-based care coordination and care management to members.
- Inform and educate members about health care programs relevant to their personal health needs.
- Engage members in discussions about adherence to personal health goals.
- Respond to inquiries from members.
- Support clinical operations through provider and member activities.
- Complete member telephonic and/or field-based health screenings and comprehensive health assessments.
- Perform care planning duties, including visits to members’ homes and/or facilities as needed to support complex and specialty populations.
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Other incentives
- Annual incentive bonus plan, subject to its terms and conditions
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
