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 to address personal health needs, engages members in discussions about adherence to health goals, responds to member inquiries, and supports clinical operations through provider and member activities. Responsibilities include completing telephonic and/or field-based health screenings, comprehensive health assessments, and care planning for complex and specialty populations. The role may require visits to members’ homes and/or facilities.
Requirements
- Be a Registered Nurse (RN) with 2 years of direct clinical care to consumers in a clinical setting, or hold one of the specified licenses: unrestricted LPC (Texas), LMSW (Texas), LCPC (Illinois), LCSW (Illinois or New Mexico), LMFT (Illinois or New Mexico), LPCC (New Mexico), LISW (New Mexico), or LMHC (New Mexico), with 2 years of clinical practice experience.
- Hold a 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.
- Have 3 years of wellness or managed care experience presenting clinical issues to members and physicians.
- Know the health and wellness marketplace and employer trends.
- Have verbal and written communication skills, including discussing medical needs with members and interfacing with internal staff and management, external vendors, and community resources.
- Have analytical experience, including medical data analysis.
- Have PC proficiency, including Word, Excel, PowerPoint, databases, and web-based applications.
- Have a current unrestricted driver’s license, transportation, and applicable insurance.
- Be able and willing to travel within the assigned territory.
Nice To Haves
- 3 years of direct clinical experience.
- Patient education experience.
- Condition Management experience.
- Bilingual fluency 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 experience.
- 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 health care programs that address their personal health needs.
- Engage members in discussions about adherence to their personal health goals.
- Respond to member inquiries.
- Support clinical operations with provider and member activities.
- Complete telephonic and/or field-based health screenings and comprehensive health assessments.
- Perform care planning for complex and specialty populations.
- Visit members’ homes and/or facilities when needed.
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 plan terms and conditions
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
