Government Programs Care Manager III - Work From Home

Health Care Service Corp.; United States; Remote; USD 42,000 - 76,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) savings plan

Pension plan

Paid time off

Tuition reimbursement

Job summary

Health Care Service Corporation is seeking a qualified Care Coordinator to provide telephonic and field-based care management. You will educate members on health programs, discuss personal health goals, and support clinical operations with providers and member activities.

Travel to member homes or facilities may be required to support complex populations. Primary responsibilities include conducting health screenings, comprehensive assessments, and developing care plans in collaboration with

Qualifications

• RN license with 2 years clinical care experience.
• For compact licenses, obtain RN licensure in state of operations within 90 days of hire.
• 3 years wellness or managed care experience with clinical issues

Responsibilities

• Provide care coordination to members via telephonic and field-based care management.
• Educate members on health care programs to address personal health needs.
• Engage members in discussions of personal health goals and respond to inquiries.
• Complete health screenings, health assessments, and care planning.
• May visit members in their homes or facilities to support complex populations.

Skills

Care coordination

RN license

Verbal communication

Data analysis

Education

Bachelor’s degree in nursing

Bachelor’s degree in social sciences

Tools

Word

Excel

PowerPoint

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.

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), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience.
• 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.
• 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.
• High-needs children: Bachelor’s degree in nursing, social sciences, social work, or related field (1) year of supervised clinical experience in a human-services field.

Additional State Specific Requirements

• Persons who are Elderly Waiver Care Coordinators must meet one (1) of the four (4) following requirements: Registered Nurse (RN) licensed in Illinois Bachelor’s degree in nursing, social sciences, social work, or related field Licensed Practical Nurse (LPN) with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly and/or authorizing service provisions, One (1) year of satisfactory program experience, which is defined as assessment, provision, and/or authorization of formal services for the elderly, may replace one year of college education, at least four (4) years of experience replacing baccalaureate degree Persons with Disabilities Waiver Care Coordinators must meet one (1) of the nine (9) following requirements: Registered Nurse (RN) Licensed Clinical Social Worker (LCSW) Licensed Marriage and Family Therapist (LMFT) Licensed Clinical Professional Counselor (LCPC) Licensed Professional Counselor (LPC) Doctor of Philosophy (PhD) Doctorate in Psychology (PsyD) Bachelor’s or master’s Degree prepared in human services related field Licensed Practical Nurse (LPN) Persons with Brain Injury Waiver Care Coordinators must meet one (1) of the seven (7) following requirements: Registered Nurse (RN) licensed in Illinois Certified or Licensed social worker Unlicensed social worker: minimum of bachelor’s degree in social work, social sciences, or counseling Vocational specialist: certified Rehabilitation counselor or at least three (3) years’ experience working with people with disabilities Licensed Clinical Professional Counselor (LCPC) Licensed Professional Counselor (LPC) Certified Case Manager (CCM) Persons with HIV/AIDS Waiver Care Coordinators must meet one (1) of the three (3) following requirements: A Registered Nurse (RN) licensed in Illinois and a bachelor’s degree in nursing, social work, social sciences, or counseling or one (1) years of case management experience. A Social worker with a bachelor’s degree in either social work, social sciences, or counseling (A Bachelor of Social Work or a Master of Social Work from a school accredited by any organization nationally recognized for the accreditation of schools of social work is preferred). Individual with a bachelor’s degree in a human services field (including, but not limited to sociology, special education, rehabilitation counseling) with a minimum of one (1) years of case management experience. In addition, it is mandatory that the Care Coordinator for Enrollees within the Persons with HIV/AIDS Waiver have experience in working with racial and ethnic minorities, as well as one or more of the following: Domestic Abuse The lesbian, gay, bisexual, transgender, queer (LBGTQ+) community Persons living with HIV/AIDS, and Persons with substance use disorders Texas Only: Level 3 children with behavioral health issues-experience in working with children and young adjusts with similar conditions or behaviors in three of the last 5 years

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.
• Required field-based care near Albuquerque, NM.

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, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

• 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
• Other incentives

Base Pay Range $30.45 - $54.98. Exact compensation may vary based on skills, experience, and location. This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

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.

Company Culture & Values

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.

Contact & Additional Information

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.

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 © Copyright 2025 Health Care Service Corporation. All Rights Reserved.