Medical Management Specialist (Farmington, NM)

Health Care Service Corporation; Farmington (NM); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a purpose-driven company that prioritizes employee development and offers a rewarding career in healthcare. This role involves conducting medical management and health education programs for customers on government health care programs. You'll perform assessments, care planning, and coordination, representing the company to members and state regulators. With a focus on professional growth, this position provides an opportunity to make a significant impact in the lives of others while working in a supportive environment that values diversity and inclusion.

Benefits

Health and wellness benefits

401(k)

Pension

Paid time off

Parental leave

Disability insurance

Life insurance

Employee assistance

Paid holidays

Tuition reimbursement

Qualifications

• 2 years of direct clinical care experience in a clinical setting.
• Current, valid, unrestricted license in the state of operation.

Responsibilities

• Conduct medical management and health education programs.
• Gather and analyze data for regulatory reports.

Skills

Verbal and written communication skills

Analytical experience

Knowledge of health and wellness marketplace

Ability to travel

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Clinical Social Worker (LCSW)

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Database management

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 invests in your professional development.

Job Summary

This position is responsible for conducting medical management and health education programs for customers on government health care programs. Key responsibilities include gathering, analyzing, and providing data for regulatory reports. The role involves performing assessments, care planning, and care coordination both in the member/family home and telephonically. The position represents the company to members, providers, and state regulators.

Required Job Qualifications:

• Registered Nurse (RN), Licensed Professional Counselor (LPC), Licensed Clinical Professional Counselor (LCPC), Licensed Master Social Worker (LMSW), Licensed Social Worker (LSW), Licensed Clinical Social Worker (LCSW), OR Licensed Mental Health Counselor (LMHC) with 2 years of direct clinical care experience in a clinical setting.
• Current, valid, unrestricted license in the state of operation (or reciprocity). If holding a compact license and changing permanent residence to the state of operation, an active, unrestricted RN license in the new state must be obtained within 90 days of hire.
• Knowledge of the health and wellness marketplace and employer trends.
• Excellent verbal and written communication skills, including discussing medical needs with members and interfacing with internal staff, management, external vendors, and community resources.
• Analytical experience, including medical data analysis.
• Proficiency in PC applications such as Word, Excel, PowerPoint, database management, and web-based applications.
• Current, unrestricted driver's license, transportation, and applicable insurance.
• Ability and willingness to travel within the assigned territory.

Preferred Job Qualifications:

• At least 1 year of wellness or managed care experience.
• 3 years of 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.

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

Additional Information

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, we offer a comprehensive benefits package 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.

The offered compensation varies based on skills, education, and experience, and is aligned with an annual incentive bonus plan subject to plan terms.

HCSC Employment Statement

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.

Base Pay Range

$26.37 - $58.19