Government Programs Care Manager III

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

Job summary

Join a purpose-driven company that values employee development and offers a supportive environment. This role focuses on care coordination for members through telephonic and field-based management. You will educate and engage members on health goals while supporting clinical operations. Ideal candidates will have a strong clinical background and excellent communication skills. This is a fantastic opportunity to make a difference in the lives of individuals while advancing your career in a rewarding setting. Be part of a team that prioritizes growth, inclusivity, and exceptional care.

Benefits

Health and wellness benefits

401(k)

Paid time off

Parental leave

Disability insurance

Life insurance

Employee assistance programs

Tuition reimbursement

Paid holidays

Qualifications

• 2 years of direct clinical care experience required.
• Strong analytical skills for medical data analysis.
• Experience in patient education and condition management.

Responsibilities

• Provide care coordination via telephonic and field-based management.
• Complete health screenings and care planning for members.
• Engage with members about healthcare programs and personal health goals.

Skills

Verbal and written communication skills

Analytical skills

Knowledge of health and wellness marketplace

Bilingual in English and Spanish

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

Word

Excel

PowerPoint

Databases

Web-based applications

Job description

At HCSC, our employees are the cornerstone of our business and the foundation of 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 invests in your professional development.

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 about healthcare programs, engaging them in discussions about adherence to personal health goals, responding to inquiries, and supporting clinical operations with provider and member activities. Responsibilities include completing telephonic and/or field-based health screenings, comprehensive health assessments, and care planning, which may involve visits to members' homes or facilities, especially for complex and specialty populations.

Required Job Qualifications:

• Registered Nurse (RN) with 2 years of direct clinical care experience or an 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), with 2 years of clinical practice experience.
• 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.
• Plus 3 years of wellness or managed care experience involving clinical issues with members and physicians.
• Knowledge of the health and wellness marketplace and employer trends.
• Strong verbal and written communication skills for discussing medical needs with members and interfacing with internal staff, management, external vendors, and community resources.
• Analytical skills, including medical data analysis.
• Proficiency in Word, Excel, PowerPoint, databases, 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:

• 3 years of direct clinical experience.
• Experience in patient education and condition management.
• 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 and population management.

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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 to support our employees' lives outside of work, including health and wellness benefits, 401(k), pension, paid time off, parental leave, disability insurance, life insurance, employee assistance programs, paid holidays, tuition reimbursement, and more. Learn more at https://careers.hcsc.com/totalrewards.

The offered compensation varies based on skills, education, knowledge, and experience. This role is eligible for an annual incentive bonus plan, subject to plan terms and conditions.

HCSC Employment Statement:

We are an Equal Opportunity Employer dedicated to a respectful 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

$26.37 - $58.19