Government Programs Care Manager II

Health Care Service Corp.; Downers Grove (IL); Remote; USD 35,000 - 63,000; Full time

Job summary

Health Care Service Corporation is seeking a care coordination professional to support members through telephonic and field-based care management. You will educate members on health care programs, address personal health needs, and engage in goal-oriented discussions while supporting clinical operations and external partners.

Qualifications include licensed RN or allied professionals with state licensure; willingness to travel, strong communication, and prior wellness or managed care experience.

Qualifications

• RN or licensure in state of operation with 3 years wellness or managed care experience.
• Illinois-specific requirement for high-needs children:Bachelor’s degree in nursing, social sciences, social work, or related field and 1 year supervised clinical experience.

Responsibilities

• Provide care coordination to members via telephonic or field-based care management.
• Educate members on health care programs to address personal health needs.
• Engage members in discussions of adherence to personal health goals and respond to inquiries.
• Complete health screenings, comprehensive health assessments and care planning; may visit homes or facilities.

Skills

Verbal communication

Written communication

PC proficiency

Driver's license

Travel

Education

Bachelor’s degree in nursing, social sciences, social work, or related field

Tools

Word

Excel

PowerPoint

Database experience

Web-based applications

Job description

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.

Job Summary

This position is responsible for to provide 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.

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), 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. 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.
• Additional State Specific Requirements Illinois Only High-needs children: Bachelor’s degree in nursing, social sciences, social work, or related field (1) year of supervised clinical experience in a human- services field

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.

Pay Transparency Statement

Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range

Base Pay Range $25.14 - $45.44 Exact compensation may vary based on skills, experience, and location.

Remote Work Policy

This is a Remote/Work-From-Home role. Sponsorship is not available. This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

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. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

Additional Information

All applications, including resumes, must be submitted through HCSC's Career website on-line application process. Please note that only requests for accommodations in the application process will be returned. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.