Government Programs Care Manager III(Albuquerque, NM)

Health Care Service Corporation; Albuquerque (NM); On-site; Full time

Job summary

An established industry player is seeking a dedicated Medical Management Specialist to join their team in Albuquerque. This remote role offers the chance to conduct vital health education programs and engage in medical management for government health care initiatives. You will play a key role in assessing patient needs, coordinating care, and providing essential support to members and providers. The ideal candidate will possess a strong clinical background and be skilled in communication and data analysis. Join a purpose-driven organization that values employee growth and offers a supportive environment for professional development.

Qualifications

• 2 years direct clinical care experience in a clinical setting.
• Current, valid, unrestricted license in the state of operations.
• Experience in managing complex cases and patient education.

Responsibilities

• Conduct medical management and health education programs.
• Gather and analyze data for regulatory reports.
• Perform assessments and care planning in member homes.

Skills

Verbal and written communication skills

Analytical experience

Knowledge of health and wellness marketplace

Ability to travel

Bilingual in English and Spanish

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Licensed Mental Health Counselor (LMHC)

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Database applications

Job description

Medical Management Specialist (Albuquerque, NM)

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

Job Summary

This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing data for regulatory reports. Perform assessments, care planning and care coordination in the member/family home and telephonically. This position will represent the company to members, providers and state regulators.

Required Job Qualifications:

• Registered Nurse (RN), Licensed Professional Counselor (LPC), Licensed Clinical Professional Counselor (LCPC), Licensed Master Social Worker (LMSW), Licensed Social Worker (LSW), Licensed Clinical Social Worker (LCSW) OR Licensed Mental Health Counselor (LMHC) with 2 years direct clinical care to the consumer in a clinical setting.
• Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
• Knowledge of the health and wellness marketplace and employer trends.
• Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
• Analytical experience including medical data analysis.
• PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
• Current unrestricted driver’s license, transportation and applicable insurance.
• Ability and willingness to travel within assigned territory.

Preferred Job Qualifications:

• Plus 1 year wellness or managed care experience.
• 3 years clinical experience.
• Patient education experience.
• Condition Management experience.
• Bilingual in English and Spanish.
• Experience in managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management or nationally recognized health care certification.

This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$26.37 - $58.19