Government Programs Care Manager III – Work From Home

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

Job summary

Health Care Service Corporation (HCSC) seeks a remote care coordinator to deliver telephonic and field-based care management for members. You will educate members on health programs, discuss adherence to goals, and handle inquiries while supporting clinical operations with providers and member activities.

The role requires NM licensure or reciprocity, 2 years of clinical care, and 3 years of wellness/managed care experience, with strong communication and MS Office skills.

Qualifications

• Current, valid, unrestricted license in the state of New Mexico (or reciprocity).
• 2 years direct clinical care experience in a clinical setting.
• Plus 3 years’ wellness or managed care experience.
• Proficient in Word, Excel, PowerPoint and web-based applications.

Responsibilities

• Provide care coordination to members via telephonic and field-based care management.
• Conduct member health screenings and comprehensive health assessments.
• Support clinical operations with provider and member activities; may visit homes or facilities.

Skills

Verbal communication

Written communication

Analytics

MS Office

Mobility/travel willingness

Education

Registered Nurse (RN) license in NM

Licensed Professional Counselor (LPC) license / other NM licenses

Tools

Word

Excel

PowerPoint

Web-based applications

Job description

Remote

NM - Albuquerque

NM - Raton

NM - Taos

NM - Las Cruces

NM - Springer

Full time

R0056107

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 https://careers.hcsc.com/totalrewards .

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.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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