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Health Care Service Corporation · 2 days ago

Government Programs Care Manager III (TX Counties - Brazos, Limestone, Freestone. Leon, Falls, Robertson, Madison, Milam, Grimes, Burleson, Washington, Bell)

Waco, TX

Full-time

Hybrid

Mid, Senior Level

$26.90/hr - $59.35/hr

5+ years exp

Health Care Service Corporation is a purpose-driven company that invests in employee professional development. The Government Programs Care Manager III is responsible for providing care coordination and transition planning to members, engaging them in discussions about their health goals, and conducting health assessments and care planning duties in various settings.

Health InsuranceInsurance

Growth Opportunities

No H1B

Responsibilities

Provide care coordination/transition planning 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 members in discussions of adherence to personal health goals

Respond to inquiries from members

Support clinical operations with provider and member activities

Transition members to adult programs

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

Registered Nurse (RN)Clinical practice experienceManaged care experienceMedicaid experienceCase management experienceBilingual in EnglishSpanishAnalytical experiencePC proficiencyPopulation ManagementCommunity outreach experienceCommunication skills

Required

Registered Nurse (RN) with a current and unrestricted license to practice in Texas, with 2 years direct clinical care to the consumer in a clinical setting experience, Licensed Professional Counselor (LPC), Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW) or Licensed Marriage Family Therapist (LMFT) with 2 years of clinical practice experience and a Texas current and unrestricted 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

Experience working with level 3 children with behavioral health issues and experience working with children and young adults with similar conditions or behaviors in three (3) of the last five (5) years

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