Health Care Service Corporation · 4 hours ago
Government Programs Care Manager III - 743
Health Care Service Corporation is a purpose-driven company that invests in the professional development of its employees. The Government Programs Care Manager III is responsible for providing care coordination to members through telephonic and field-based management, engaging them in discussions about their health goals and supporting clinical operations.
Health InsuranceInsurance
Responsibilities
Provide care coordination to members via telephonic and/or field-based care management
Inform and educate members on health care programs to address their personal health needs
Engage the member in discussion of adherence to personal health goals
Respond to inquiries from members
Support clinical operations with provider and member activities
Complete member telephonic and/or field-based health screenings
Conduct comprehensive health assessments and care planning duties which may require visits to members’ homes and/or facilities
Qualification
Required
Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or, unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor (LMHC, NM) with 2 years of clinical practice experience
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
PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications
Current unrestricted driver's license, transportation and applicable insurance
Ability and willingness to travel within assigned territory
Preferred
3 years direct clinical experience
Community Health Experience
Intake Assessment Experience
NCQA Documentation Experience
Patient education experience
Condition Management experience
Bilingual in English and Spanish
Experience in managing complex or catastrophic cases
Certification in Case Management, Training, Project Management or nationally recognized health care certification
Government Programs experience
Company
Health Care Service Corporation
Health Care Service Corporation is a customer-owned health insurance company.
Funding
Current Stage
Late StageRecent News
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