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Health Care Service Corporation · 2 hours ago

Government Programs Care Manager III

Nashville, TN

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 the professional development of its employees. This position is responsible for providing care coordination to members through telephonic and field-based care management, educating them on health care programs, and supporting clinical operations.

Health InsuranceInsurance

Growth Opportunities

Responsibilities

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

Inform and educate them on health care programs to address their personal health needs

Engaging the member in discussion of adherence to personal health goals

Responding to inquiries from members

Supporting clinical operations with provider and member activities

Complete member telephonic and/or field-based health screenings

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

Qualification

Registered Nurse (RN)Licensed Professional Counselor (LPC)Licensed Clinical Social Worker (LCSW)3 years wellness experienceAnalytical experiencePC proficiencyPatient education experienceCondition Management experienceCertification in Case ManagementGovernment Programs experiencePopulation ManagementBilingual in EnglishSpanish

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