Medical Management Specialist

w3r Consulting; Illinois; Sur place; USD 65 000 - 90 000; Plein temps

Résumé du poste

w3r Consulting seeks qualified healthcare professionals to conduct medical management and health education programs for government-covered customers. The role involves data collection, analysis, and reporting for regulatory purposes, plus acting as the company liaison to members.

Ideal candidates hold RN/LPC/LMSW licenses, have clinical experience, and can travel within the assigned territory to support members and partners.

Qualifications

• Registered Nurse (RN) with 3 years direct clinical care in a clinical setting.
• Current, valid, unrestricted license in the state of operations.
• Plus 3 years wellness or managed care experience with patients/members.
• Knowledge of the health and wellness marketplace and employer trends.
• Verbal and written communication with members and internal/external stakeholders.
• Analytical experience including medical data analysis.
• Driver's license and ability to travel within territory.
• PC proficiency with Word, Excel, PowerPoint and related tools.

Responsabilités

• Conduct medical management and health education programs for customers on government health care programs.
• Gather, analyze and provide data for regulatory reports.
• Represent the company to members and coordinate with vendors and community resources.

Formation

RN license (Illinois or applicable state)

LPC license

LMSW license

Outils

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Database experience

Web-based applications

Description du poste

Location: Winnebago, Boone County, Ogle County & Stephenson County (in or around the Rockford Area)

This position is responsible for conducting medical management and health education programs for customers on government health care programs. This role will include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.

Job Description:

This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members.

JOB QUALIFICATIONS

• Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
• 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.
• Current driver's license, transportation and applicable insurance.
• Ability and willingness to travel within assigned territory.
• PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.

PREFERRED JOB QUALIFICATIONS:

• 3 years clinical experience.
• Bilingual in English and Spanish.
• Transition of Care experience.
• Experience in managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management or nationally recognized health care certification.