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Health Care Service Corporation · 1 day ago

BH Government Programs Care Manager III

Albuquerque, NM

Full-time

Hybrid

Mid, Senior Level

$26.90/hr - $59.35/hr

5+ years exp

Health Care Service Corporation (HCSC) is a purpose-driven company that invests in the professional development of its employees. The BH Government Programs Care Manager III role involves providing care coordination to members through telephonic and field-based management, supporting clinical operations, and conducting health screenings and assessments.

Health InsuranceInsurance

Growth Opportunities

Responsibilities

Provide care coordination to members via telephonic and/or field based care management

Inform and educate members on health care programs

Engage the member in adherence to personal health goals

Respond to inquiries from members

Support the clinical operations department with their provider and member activities

Complete member telephone and/or field based health screenings

Conduct comprehensive health assessments and care planning duties which may require visits to members’ home and/or facilities to support complex and specialty populations

Qualification

Registered Nurse (RN)Licensed Professional CounselorClinical practice experienceWellness experienceMedical management programsHealth education programsAnalytical experiencePC proficiencyPatient education experienceBehavioral Health experienceBilingual NavajoCertification in Case ManagementGovernment Programs experiencePopulation ManagementBilingual EnglishBilingual SpanishVerbal communication skillsWritten communication skills

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, NM), 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

Experience handling medical management programs and health educations programs in an independent manner

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

Ability and willingness to travel within assigned territory