Government Programs Care Manager III

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

Job summary

A leading health care organization is seeking a dedicated care coordinator to manage member health needs through telephonic and field-based support. This remote role requires a valid nursing or counseling license and experience in clinical care. The successful candidate will engage with members to promote adherence to health goals and facilitate comprehensive assessments. Strong communication skills and analytical abilities are essential for success in this position.

Qualifications

• 2 years of direct clinical care experience required.
• Current, valid, unrestricted license in the state of operations.
• 3 years of wellness or managed care experience preferred.

Responsibilities

• Provide care coordination via telephonic and/or field-based management.
• Complete member health screenings and comprehensive health assessments.
• Engage members in discussions about adherence to personal health goals.

Skills

Communication

Analytical Skills

Bilingual in English and Spanish

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

PC 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.

This position is responsible for providing care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs, addressing their personal health needs, engaging members in discussions about adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This role involves completing 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 to support complex and specialty populations.

Required Job Qualifications:

• Registered Nurse (RN) with 2 years of direct clinical care in a clinical setting, or 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 operations (or reciprocity). For licensees relocating to the state of operations, active, unrestricted RN licensure must be obtained within 90 days of hire.
• Plus 3 years of wellness or managed care experience addressing clinical issues with members and 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 skills, including medical data analysis.
• Proficiency in PC applications such as Word, Excel, PowerPoint, database management, and web-based applications.
• Current, unrestricted driver’s license, reliable 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.
• Experience in condition management.
• Bilingual in English and Spanish.
• Experience managing complex or catastrophic cases.
• Certification in case management, training, project management, or other recognized healthcare certification.
• Experience with government programs.
• Population management experience.

Telecommute:
This is a remote role: candidates must reside within 250 miles of the office or within the state of operation.

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Compensation: $26.37 - $58.19 per hour, based on skills, experience, and location.

HCSC Employment Statement:

We are an Equal Opportunity Employer committed to a diverse and inclusive environment. 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.

Learn more about our benefits at https://careers.hcsc.com/totalrewards.