Government Programs Care Manager III – Work From Home

Enterprise HCM; Albuquerque (NM); Remote; USD 42,000 - 76,000; Full time

Job summary

HCSC is seeking a remote-oriented care coordination professional to support members via telephonic and field-based care management. The role focuses on educating members about health programs, discussing personal health goals, and addressing inquiries while supporting clinical operations with provider and member activities.

The position requires an NM license (or reciprocity) and at least 2 years of direct clinical care, with travel within Dona Ana and surrounding NM areas as needed.

Qualifications

• Licensed clinical professional with 2+ years in a clinical setting.
• Current, valid unrestricted license in NM or reciprocity.
• Experience presenting clinical issues with members/physicians.
• Ability to travel within assigned territory.

Responsibilities

• Provide care coordination to members via telephonic or field-based care management.
• Educate members on health care programs and address personal health needs.
• Conduct health screenings and comprehensive health assessments.
• Support clinical operations with provider and member activities.

Skills

Care coordination

Verbal communication

Analytical thinking

PC proficiency (Word/Excel/PowerPoint)

Education

RN license (NM) or equivalent clinical license

2 years direct clinical care

Tools

Microsoft Office

Job description

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.

This position is responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete 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 direct clinical care to the consumer in a clinical setting or, unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX ), Licensed Clinical Professional Counselor (LCPC, IL) or 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), Licensed Social Worker (LSW, IL), or Licensed Mental Health Counselor (LMHC, NM) with 2 years of clinical practice experience.
• Current, valid, unrestricted license in the state of New Mexico (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.
• Plus 3 years’ wellness or managed care experience presenting clinical issues with members/physicians.
• 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:

• 3 years direct 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.
• Government Programs experience
• Population Management
• This is a field-work role that requires 2-3 days a week travel (depending on Member visits schedule) to Dona Ana (NM) and its surroundings – as far as Raton, NM.
• Work Hours are 8 AM to 5 PM MST Monday through Friday.

#LI-FW1

#LI-Remote

This is a Remote/Work-From-Home role for NM (servicing Dona Ana and its surroundings – as far as Raton, NM).

Sponsorship is not available

Compensation: $30.45 - $54.98

Exact compensation may vary based on skills, experience, and location

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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards