Government Programs Care Manager ll (Albuquerque, NM)

Health Care Service Corporation; Santa Fe (NM); Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player seeks a dedicated care coordinator to join their team. This remote role focuses on providing essential care management and support to members, ensuring they receive the guidance needed to navigate their health care journey. With a commitment to employee development, this company fosters a culture of growth and empowerment, making it an ideal place for professionals passionate about making a difference in the health care sector. Join a purpose-driven organization that values your contributions and invests in your future.

Benefits

Health and wellness benefits

401(k)

Paid time off

Parental leave

Disability insurance

Life insurance

Tuition reimbursement

Qualifications

• 3+ years of wellness or managed care experience.
• Strong analytical experience with medical data analysis.

Responsibilities

• Provide care coordination via telephonic and field-based management.
• Educate members on health care programs and personal health goals.

Skills

Verbal and written communication skills

Analytical skills

Knowledge of health and wellness marketplace

Proficiency in Word, Excel, PowerPoint

Bilingual in English and Spanish

Education

Licensed as a Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

Database experience

Web-based applications

Job description

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 will invest in your professional development.

Job Summary

This position is responsible for providing care coordination to members via telephonic and/or field-based care management. The role involves informing and educating members on health care programs to address their personal health needs, engaging members in discussions about adherence to personal health goals, responding to inquiries, and supporting clinical operations, provider, and member activities. This includes completing member telephonic and/or field-based health screenings, comprehensive health assessments, and care planning, which may require visits to members' homes and/or facilities.

Required Job Qualifications

• Licensed as a Registered Nurse (RN), Licensed Professional Counselor (LPC, TX), Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL), 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).
• Current, valid, unrestricted license in the state of operation (or reciprocity). For licensees moving to the state of operation, active, unrestricted RN licensure must be obtained within 90 days of hire.
• At least 3 years of wellness or managed care experience involving clinical issues with members/physicians.
• Knowledge of the health and wellness marketplace and employer trends.
• Strong verbal and written communication skills, including discussing medical needs with members and interfacing with staff, management, vendors, and community resources.
• Analytical experience, including medical data analysis.
• Proficiency in Word, Excel, PowerPoint, database experience, and web-based applications.
• Current, unrestricted driver's license, transportation, and applicable insurance.
• Willingness and ability to travel within the assigned territory.

Preferred Job Qualifications

• Direct clinical experience.
• Patient education experience.
• Condition management experience.
• Bilingual in English and Spanish.
• Experience managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management, or other recognized healthcare certifications.
• Experience with government programs.

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

INAK

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Referral and Benefits

If you are being referred to this role, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement: At HCSC, we offer comprehensive benefits including health and wellness benefits, 401(k), pension, paid time off, parental leave, disability insurance, life insurance, employee assistance, paid holidays, tuition reimbursement, and more. Learn more at https://careers.hcsc.com/totalrewards. Compensation varies based on skills, education, and experience. This role may include an annual incentive bonus, subject to plan terms.

Equal Opportunity Employment

We are committed to creating a welcoming environment that respects and values diversity. 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.

Base Pay Range

$21.62 - $48.14