Government Programs Care Manager II

Health Care Service Corporation; Santa Fe (NM); Remote; USD 100,000 - 125,000; Full time

Job summary

A leading health care organization is seeking a dedicated professional for care coordination. The role involves educating members on health care programs, conducting assessments, and supporting clinical operations. This remote position requires strong communication skills and relevant clinical experience.

Benefits

Health and wellness plans

401(k)

Paid time off

Tuition reimbursement

Qualifications

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

Responsibilities

• Provide care coordination via telephonic and field-based management.
• Conduct health screenings and comprehensive assessments.

Skills

Communication

Medical Data Analysis

Bilingual in English and Spanish

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Licensed Marriage and Family Therapist (LMFT)

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 to 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 health screenings, comprehensive 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 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 involving 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, vendors, and community resources.
• Experience in medical data analysis.
• Proficiency in Word, Excel, PowerPoint, database management, 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 remote role: candidates must reside within 250 miles of the office or within the posted state.

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Pay Transparency & Benefits

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

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