Government Programs Care Manager III - Work From Home

HCSC Group; Clayton (NM); Remote; USD 42,000 - 76,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a care coordination professional to provide telephonic and field-based care management. The role educates members on health programs, supports adherence to goals, and assists with clinical operations and provider interactions.

The position involves health screenings, comprehensive assessments, and care planning, with possible home or facility visits for complex populations. Remote/WFH for NM with travel.

Qualifications

• RN or licensed mental health professional with at least 2 years of clinical practice.
• Current, valid NM license or reciprocity.
• 3 years of wellness or managed care experience.
• Ability to travel within assigned territory.
• Strong verbal and written communication skills.

Responsibilities

• Coordinate care for members by phone or in the field to inform and educate on health programs.
• Engage members in discussions of personal health goals and adherence.
• Respond to member inquiries and support clinical operations with providers.
• Complete health screenings, assessments, and care planning; may visit homes or facilities.

Skills

RN license

NM state license

2 years clinical care

Wellness experience

Verbal & written communication

Data analysis

MS Office

Driver's license

Travel willingness

Bilingual English/Spanish

Education

RN license (NM)

Licensed clinician NM

Tools

Word

Excel

PowerPoint

Database experience

Web-based applications

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.

Job Summary

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

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii .

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.

Base Pay Range

$30.45 - $54.98

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