Government Programs Care Manager II

Health Care Service Corporation; Los Alamos (NM); Remote; Full time

Job summary

A leading health care organization seeks a dedicated professional for a remote role in care coordination. The position involves engaging members in health programs, conducting assessments, and supporting clinical operations. Candidates should have relevant licenses and experience in managed care. Comprehensive benefits and a competitive salary are offered.

Benefits

401(k)

Paid Time Off

Parental Leave

Tuition Reimbursement

Qualifications

• At least 3 years of wellness or managed care experience.
• Current, valid, unrestricted license in the state of operation.

Responsibilities

• Providing care coordination via telephonic and field-based management.
• Conducting health screenings and comprehensive health assessments.

Skills

Communication

Analytical Skills

Bilingual

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

Word

Excel

PowerPoint

Job description

Job Summary

This position is responsible for providing care coordination to members via telephonic and/or field-based care management. The goal is to inform and educate members on health care programs, address their personal health needs, engage them in discussions about adherence to health goals, respond to inquiries, and support clinical operations, provider, and member activities. The role includes conducting member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning, which may involve visits to members' homes 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 relocating 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 handling clinical issues with members/physicians.
• Knowledge of the health and wellness marketplace and employer trends.
• Strong verbal and written communication skills for discussing medical needs and interfacing with staff, management, vendors, and community resources.
• Analytical skills including medical data analysis.
• Proficiency in Word, Excel, PowerPoint, database experience, and web-based applications.
• Current, unrestricted driver's license, transportation, and applicable insurance.
• Willingness and ability 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.

Additional Information

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

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Pay Transparency and Benefits

We offer comprehensive benefits including health and wellness plans, 401(k), pension, paid time off, parental leave, disability insurance, supplemental life insurance, employee assistance programs, paid holidays, tuition reimbursement, and more. Learn more at https://careers.hcsc.com/totalrewards. Compensation varies based on skills, education, and experience and may include an annual incentive bonus plan.

Equal Opportunity Employment

We are committed to a welcoming environment that respects and values diversity. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Base Pay Range

$21.62 - $48.14