Government Programs Care Manager II

Enterprise HCM; Belen (NM); Remote; USD 80,000 - 100,000; Full time

Job summary

A health care services company is looking for a qualified individual to provide telephonic care coordination and support to members. The ideal candidate will have experience in wellness or managed care and hold a relevant state license. This remote role may also require travel to visit members as necessary. Compensation ranges from $21.62 to $48.14 depending on experience.

Qualifications

• Must hold a valid unrestricted nursing or therapy license.
• 3 years of experience in wellness or managed care.
• Knowledge of health and wellness marketplace.

Responsibilities

• Provide care coordination to members.
• Educate members on health care programs.
• Complete health screenings and assessments.

Skills

Registered Nurse (RN)

Verbal and written communication skills

Analytical experience

PC proficiency

Ability and willingness to travel

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Overview

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development. 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, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting the clinical operations, provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members’ homes and/or facilities.

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 the member in discussion of adherence to personal health goals.
• Respond to inquiries from members and support clinical operations, provider and member activities.
• Complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties, which may require visits to members’ homes and/or facilities.

Required Job Qualifications

• 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), or Licensed Mental Health Counselor (LMHC, NM, NM).
• Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensees changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
• Plus 3 years’ 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.

Preferred Job Qualifications

• 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.

Travel and Telecommute

This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state. This role requires traveling to visit members.

This role may require travel to visit members.

#LI-AC1

#CA

Compensation: $21.62 - $48.14

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please visit: https://careers.hcsc.com/totalrewards