Government Programs Care Manager II

Health Care Service Corporation; Espanola (NM); Remote; Full time

Job summary

A leading health care company is seeking a qualified individual to provide care coordination through telephonic and field-based management. The role includes educating members on health care programs and supporting clinical operations. Candidates should have relevant licenses and experience in wellness or managed care, along with strong communication skills. This is a remote position requiring travel within the assigned territory.

Benefits

Health and wellness benefits

401(k)

Pension

Paid time off

Parental leave

Disability insurance

Tuition reimbursement

Qualifications

• At least 3 years of wellness or managed care experience.
• Knowledge of health and wellness marketplace.

Responsibilities

• Provide care coordination via telephonic and field-based management.
• Complete health screenings and care planning duties.

Skills

Communication

Analytical

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Master Social Worker (LMSW)

Licensed Clinical Social Worker (LCSW)

Licensed Marriage and Family Therapist (LMFT)

Licensed Professional Clinical Counselor (LPCC)

Licensed Independent Social Worker (LISW)

Licensed Mental Health Counselor (LMHC)

Tools

PC Applications

Database Experience

Job description

Job Summary

This position is responsible for providing care coordination to members via telephonic and/or field-based care management. The role involves informing and educating members on health care programs, engaging them in discussions about adherence to personal health goals, responding to inquiries, and supporting clinical operations, provider, and member activities. The position requires completing member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning duties, which may include visits to members' homes and/or facilities.

Required Job Qualifications

• Registered Nurse (RN), unrestricted Licensed Professional Counselor (LPC, TX), Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL), 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).
• Current, valid, unrestricted license in the state of operation (or reciprocity). For compact licensees changing permanent residence to the state of operation, active, unrestricted RN licensure must be obtained within 90 days of hire.
• At least 3 years of wellness or managed care experience involving clinical issues with members/physicians.
• Knowledge of the health and wellness marketplace and employer trends.
• Strong verbal and written communication skills, including discussing medical needs with members and interfacing with internal staff, management, external vendors, and community resources.
• Analytical experience, including medical data analysis.
• Proficiency in PC applications such as Word, Excel, PowerPoint, database experience, and web-based applications.
• Current unrestricted driver's license, transportation, and applicable insurance.
• Ability and willingness to travel within the assigned territory.

Preferred Job Qualifications

• 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 other recognized healthcare certifications.
• Experience with government programs.

This is a telecommute (remote) role: candidates must reside within 250 miles of the office or anywhere within the posted state.

Additional Information

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement: At Health Care Service Corporation, we offer meaningful benefits such as health and wellness benefits, 401(k), pension, paid time off, parental leave, disability insurance, supplemental life insurance, employee assistance programs, paid holidays, tuition reimbursement, and other incentives. Learn more at https://careers.hcsc.com/totalrewards. Compensation varies based on skills, education, and experience, and may include an annual incentive bonus plan.

HCSC Employment Statement

We are an Equal Opportunity Employer committed to a diverse and inclusive environment. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Base Pay Range

$21.62 - $48.14