Government Programs Care Manager l

Health Care Service Corporation; Nashville (TN); Remote; Full time

Job summary

Join a leading health care organization in Nashville as a member engagement specialist. This remote role focuses on educating members about health care programs, coordinating their medical needs, and supporting clinicians in a dynamic environment. The position requires strong communication skills and a background in social work or nursing. With a commitment to employee development, HCSC offers a rewarding career path in a purpose-driven company.

Qualifications

• 3 years of care coordination or managed care experience.
• Experience analyzing member needs and coordinating medical assistance.

Responsibilities

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

Skills

Customer service

Communication

Medical terminology

Education

Bachelor of Social Work

Bachelor of Psychology

LPN

RN

Tools

Microsoft Office

Job description

Join HCSC and Grow Your Career

At HCSC, our employees are the cornerstone of our business and the foundation of 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 invests in your professional development.

Job Summary

This position is responsible for contacting identified members to inform and educate them on health care programs, addressing their personal health plan needs, engaging members 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 systems OR RN OR 3 years of care coordination for a state-managed or waiver program OR 3 years of managed care systems experience.
• Knowledge of medical terminology
• Experience coordinating member medical needs, providing assistance, and analyzing member needs
• Proficiency in PC applications including Microsoft Office
• Customer service skills
• Strong verbal and written communication skills, including developing correspondence to members and department personnel, and coaching skills such as motivational interviewing to educate members on medical issues

Preferred Qualifications

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

Sponsorship will not be provided for this role.

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

Work Schedule: Standard 8-hour workday

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Compensation: $19.65 - $43.74 per hour

Exact compensation varies based on skills, experience, and location.

Equal Opportunity Employment

We are an Equal Opportunity Employer committed to a diverse and 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