Government Programs Care Manager III (Santa Fe, NM)

Health Care Service Corporation; Los Alamos (NM); Remote; Full time

Job summary

An established industry player is seeking a dedicated care coordinator to enhance member health through telephonic and field-based management. This remote role focuses on educating members about healthcare programs, addressing their health needs, and promoting adherence to health goals. You will engage with diverse populations, conduct assessments, and collaborate with clinical teams to ensure optimal care. With a commitment to professional development, this position offers a chance to make a significant impact in the lives of members while enjoying a comprehensive benefits package and an annual incentive bonus.

Benefits

401(k)

Paid Time Off

Parental Leave

Disability Insurance

Life Insurance

Employee Assistance Program

Tuition Reimbursement

Incentives

Qualifications

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

Responsibilities

• Provide care coordination to members via telephonic and field-based management.
• Conduct health screenings, assessments, and care planning.
• Support clinical operations with member inquiries and activities.

Skills

Clinical Care Experience

Communication Skills

Analytical Skills

Proficiency in Word, Excel, PowerPoint

Bilingual (English and Spanish)

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

Database Applications

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 will invest 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, address their personal health needs, and engage them in discussions about adherence to health goals. Responsibilities include responding to member inquiries, supporting clinical operations with provider and member activities, conducting health screenings, assessments, and care planning, which may involve home or facility visits for complex populations.

Required Job Qualifications:

• Registered Nurse (RN) with 2 years of clinical care experience 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.
• Current, valid, unrestricted license in the state of operations or reciprocity. If relocating, must obtain active, unrestricted licensure within 90 days.
• Plus 3 years of wellness or managed care experience dealing with 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.
• Analytical skills including medical data analysis.
• Proficiency in Word, Excel, PowerPoint, database, and web-based applications.
• Current, unrestricted driver's license, transportation, and 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.

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

Additional Qualifications:

• Bilingual in English and Spanish.
• Experience managing complex or catastrophic cases.
• Certifications in Case Management, Training, Project Management, or other recognized healthcare certifications.
• Experience with government programs and population management.

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

Pay Transparency and Benefits

We offer a comprehensive benefits package including health and wellness benefits, 401(k), pension, paid time off, parental leave, disability, life insurance, employee assistance, holidays, tuition reimbursement, and incentives. Learn more at https://careers.hcsc.com/totalrewards. Compensation varies based on skills, education, and experience. The role may include an annual incentive bonus.

Equal Opportunity Employment

We are committed to diversity and inclusion. 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.

Base Pay Range: $26.37 - $58.19