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

Innovative Systems Group; Taos (NM); Remote; USD 65,000 - 80,000; Full time

Job summary

A leading company in health care is seeking a Medical Management Specialist. This role involves conducting health education programs and managing medical data for government health care programs. Candidates must be licensed professionals with clinical experience. The position offers a remote work environment with occasional travel to customer homes in Taos, NM.

Qualifications

• 3 years of direct clinical care in a clinical setting.
• Current, valid, unrestricted license in the state of operations.
• 3 years of wellness or managed care experience.

Responsibilities

• Conducting medical management and health education programs.
• Gathering and analyzing data for regulatory reports.
• Representing the company to members.

Skills

Communication

Analytical Skills

Wellness

Managed Care

Education

Registered Nurse (RN)

Licensed Professional Counselor (LPC)

Licensed Master Social Worker (LMSW)

Tools

Word

Excel

PowerPoint

Job description

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

1 day ago Be among the first 25 applicants

• Remote, but candidate must reside in or near Taos, 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 position also involves representing the company to members.

JOB QUALIFICATIONS:

• Registered Nurse (RN) with 3 years of direct clinical care 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 licensees relocating to the state of operations, active, unrestricted RN licensure must be obtained within 90 days of hire.
• Plus 3 years of 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 NM driver's license, transportation, and applicable insurance (for NM).
• Ability and willingness to travel within the assigned territory.
• Proficiency in Word, Excel, PowerPoint, database experience, and web-based applications.

PREFERRED JOB QUALIFICATIONS:

• 3 years of clinical experience.
• Bilingual in English and Spanish (preferred but not required).
• Transition of Care experience.
• Experience managing complex or catastrophic cases.
• Certification in Case Management, Training, Project Management, or other 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, and Public Health

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