Government Programs Care Manager III

Health Care Service Corporation; Springfield (IL); Remote; Full time

Job summary

Join a purpose-driven company that prioritizes employee growth and development. In this remote role, you'll provide essential care coordination to members, ensuring they receive the support they need to meet their health goals. Your expertise in clinical care and strong communication skills will be vital as you engage with members and collaborate with healthcare providers. This innovative firm values diversity and offers a comprehensive benefits package, including health and wellness programs, retirement plans, and paid time off. If you're passionate about making a difference in healthcare, this opportunity is for you.

Benefits

Health and Wellness Benefits

401(k) Plan

Paid Time Off

Parental Leave

Tuition Reimbursement

Employee Assistance Program

Qualifications

• 2 years of clinical care experience as RN or licensed professional.
• Strong analytical and communication skills for member interactions.

Responsibilities

• Provide care coordination and education to members via telephonic and field-based management.
• Complete health screenings and assessments, including home visits.

Skills

Clinical Care Experience

Communication Skills

Analytical Skills

Knowledge of Health Marketplace

Bilingual (English and Spanish)

Education

Registered Nurse (RN)

Licensed Professional (LPC, LMSW, etc.)

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Database 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 goal is to inform and educate members on healthcare programs to address their personal health needs, engage them in discussions about adherence to health goals, respond to inquiries, and support clinical operations with provider and member activities. Responsibilities include completing member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning, which may involve home visits or facility visits for complex and specialty populations.

Required Job Qualifications:

• Registered Nurse (RN) with 2 years of clinical care experience or a licensed professional such as LPC, LMSW, LCPC, LCSW, LMFT, LPCC, LISW, or LMHC with 2 years of clinical practice.
• Current, valid, unrestricted license in the state of operation (or reciprocity). New licensees relocating must obtain active, unrestricted licensure within 90 days.
• At least 3 years of wellness or managed care experience, dealing with 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 and interfacing with staff, vendors, and community resources.
• Analytical skills, including medical data analysis.
• Proficiency in Word, Excel, PowerPoint, database experience, and web-based applications.
• Valid driver's license, transportation, and insurance.
• Willingness and ability to travel within the assigned territory.

Preferred Job Qualifications:

• 3+ years of clinical experience.
• Experience in Oncology and Behavioral Health Care.
• Patient education and condition management experience.
• Bilingual in English and Spanish.
• Experience managing complex or catastrophic cases.
• Certifications in Case Management, Training, Project Management, or other recognized healthcare areas.
• Experience with government programs and population management.

Telecommute Details:

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

#LI-TELECOMMUTE #LI-AK1 #INAK

Additional Information:

If referred, ask your HCSC connection about our Employee Referral process.

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

HCSC Employment Statement:

We are committed to equal opportunity employment, respecting and valuing diversity. 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