Government Programs Care Manager l

Health Care Service Corporation; Albuquerque (NM); Remote; Full time

Job summary

Join a leading health care service provider as a member contact specialist. This remote position involves educating members about health care programs, addressing their needs, and supporting clinicians. Ideal candidates will have a background in social work, psychology, or nursing.

Qualifications

• 3 years managed care experience or 3 years care coordination.
• Proficiency in PC applications including Microsoft Office.

Responsibilities

• Contact members to inform and educate about health care programs.
• Support clinicians in Medical Management department activities.

Skills

Customer service skills

Strong verbal and written communication skills

Knowledge of medical terminology

Education

Bachelor of Social Work or Psychology

LVN, LPN

RN

Tools

Microsoft Office

Job description

Join HCSC and Grow with Us

At HCSC, our employees are the cornerstone of our success. We provide curated development plans to foster growth and rewarding careers. Join us and be part of a purpose-driven company investing in your professional development.

Job Summary

This position involves contacting identified members to inform and educate them about health care programs, addressing their personal health plan needs, engaging them in discussions about adherence to their health plans, responding to inquiries, and supporting clinicians in the Medical Management department with provider and member activities.

Job Requirements

• Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care experience.
• Knowledge of medical terminology
• Experience coordinating member medical needs, providing assistance, and analyzing needs
• Proficiency in PC applications including Microsoft Office
• Customer service skills
• Strong verbal and written communication skills, including developing correspondence and motivational interviewing skills to educate members on medical issues

Preferred Qualifications

• Case Management experience - highly preferred
• Professional communication skills and phone experience - highly preferred
• LPN certification - highly preferred
• Nurses must be licensed in their state(s)
• Payor insurance experience

Sponsorship is not available for this role.

This is a remote role; candidates must reside within 250 miles of the office or within the state posted.

Work Schedule: Standard 8-hour days

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Compensation: $19.65 - $43.74 per hour, based on skills, experience, and location.

Equal Opportunity Employment

HCSC is committed to an inclusive environment. 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.

Learn more about our benefits at https://careers.hcsc.com/totalrewards