Medical Management Specialist - Registered Nurse (RN), Licensed Professional Counselor (LPC), o[...]

Innovative Systems Group; Raton (NM); Remote; USD 66,000 - 121,000; Full time

Job summary

A leading company is seeking a Medical Management Specialist who is a Registered Nurse, LPC, or LMSW. This role involves conducting health education programs and data analysis for regulatory reports. The position is primarily remote with some travel required. Ideal candidates will have significant clinical experience and strong communication skills.

Qualifications

• 3 years of direct clinical care experience required.
• Current, valid, unrestricted license in the state of operation.

Responsibilities

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

Skills

Communication

Medical Data Analysis

Wellness

Managed Care

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Master Social Worker (LMSW)

Tools

PC Applications

Word

Excel

PowerPoint

Job description

Medical Management Specialist - Registered Nurse (RN), Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW)

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• Remote, but candidate must reside in or near Raton, NM
• 90%-95% remote with some visits to customer homes at least 1-3 times per month depending on business needs.
• 40 hrs per week. Typical schedule is M-F, 8:00-4:30 CST with 30-min lunch break.

JOB PURPOSE:

This position is responsible for conducting medical management and health education programs for customers on government health care programs. This role includes gathering, analyzing, and providing data for regulatory reports. The role will also involve representing the company to members.

JOB QUALIFICATIONS:

• Registered Nurse (RN) with 3 years of direct clinical care experience 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 operation (or reciprocity). For licensees relocating 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 presenting 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 internal staff, management, external vendors, and community resources.
• Experience in medical data analysis.
• Current NM driver's license, transportation, and applicable insurance (for NM residents).
• Willingness and ability to travel within the assigned territory.
• Proficiency in PC applications such as Word, Excel, PowerPoint, database experience, and web-based applications.

PREFERRED JOB QUALIFICATIONS:

• At least 3 years of clinical experience.
• Bilingual in English and Spanish (preferred but not required).
• Experience with Transition of Care.
• Experience managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management, or other nationally recognized healthcare certifications (preferred but not required).

Seniority level

• Associate

Employment type

• Contract

Job function

• Health Care Provider, Other, and Administrative

Industries

• IT Services and IT Consulting, Hospitals and Health Care, Public Health

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