RN | LPC | LMSW | Medical Management Specialist

Innovative Systems Group; Illinois; Hybrid; USD 76,000 - 83,000; Part time

Job summary

Innovative Systems Group seeks a Medical Management Specialist to oversee medical management and health education programs for government health care program customers. You will gather and analyze data for regulatory reports and serve as the representative of the company to members.

The role requires clinical licensure (RN, LPC or LMSW) with relevant experience, and offers hybrid work with travel within the territory.

Qualifications

• RN or LPC/LMSW with clinical practice license in operations state.
• Active, unrestricted RN/LPC/LMSW license within 90 days if relocation.
• 3 years wellness or managed care experience with clinical issues.
• Verbal and written communication with members, vendors and staff.
• Strong analytical skills with medical data analysis.
• Current driver''s license and ability to travel.
• Proficient in Word, Excel, PowerPoint; experience with databases and web-based apps.
• Knowledge of health and wellness marketplace and employer trends.

Responsibilities

• 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.

Skills

Communication

Clinical experience

Analytical skills

PC proficiency

Travel readiness

Health marketplace knowledge

Bilingual English/Spanish

Education

RN license

LPC/LMSW license

Active unrestricted licensure

Tools

Word

Excel

PowerPoint

Databases

Web-based apps

Job description

Job Title: Medical Management Specialist

Location: Winnebago, Boone County, Ogle County & Stephenson County | Hybrid

Duration: 5+ months contract to hire

Pay rate: $40.00/hr on W2 or $80k conversion salary

JOB PURPOSE:

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.