Member Care Coordinator

Integrated Resources, Inc.; Farmington (NM); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading healthcare organization is seeking a Member Care Coordinator to conduct medical management and health education programs for customers on government health care programs. This role involves gathering and analyzing data for regulatory reports while representing the company to members. The ideal candidate will have a nursing or counseling background with significant clinical experience and strong communication skills.

Qualifications

• Registered Nurse (RN) or LPC/LMSW with specific clinical experience.
• 3 years of wellness or managed care experience.

Responsibilities

• Conduct medical management and health education programs.
• Gather and analyze data for regulatory reports.
• Represent the company to members.

Skills

Communication

Analytical Skills

Education

Bachelor’s Degree

Tools

Word

Excel

PowerPoint

Job description

Job Title: Member Care Coordinator

Location: Farmington, NM (Remote + Field Visit)

Duration: 6+ months (possible extension)

Schedule: 40 hrs, Mon-Fri, 8 am - 4:30 pm

Description:

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 member care coordinator will represent the company to members.

Job Purpose:

• Conduct medical management and health education programs for customers on government health care programs. Responsibilities include gathering, analyzing, and providing data for regulatory reports. The role involves representing the company to members.

Qualifications:

• Registered Nurse (RN) with a Bachelor’s Degree and 3 years pediatric clinical care experience, or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW) with at least 2 years of clinical practice to obtain LPC or LMSW license.
• Current, valid, unrestricted license in the state of operations (or reciprocity).
• For licensees changing residence to the state of operations, active, unrestricted RN licensure in the new state 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.
• 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.
• Current driver's license, transportation, and applicable insurance.
• Ability and willingness to travel within the assigned territory.
• Proficiency in PC applications such as Word, Excel, PowerPoint, database experience, and web-based applications.