Government Programs Care Manager III

About the role

This position is responsible to provide care coordination to members via telephonic and/or field-based care management to 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, and supporting clinical operations with provider and member activities. This position will be required to 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.

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 members in discussions 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
• Support complex and specialty populations through home and facility visits

Requirements

• 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).
• 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.

Qualifications

• 3 years direct clinical 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
• Population Management

Skills

• Excellent verbal and written communication skills.
• Strong analytical skills.
• Proficiency in Microsoft Office Suite.
• Ability to manage multiple tasks and prioritize effectively.
• Effective problem-solving and decision-making skills.

Benefits

HCSC offers a comprehensive benefits package that includes:

• Health Insurance
• Retirement Savings Plan
• Flexible Spending Accounts
• Employee Assistance Program
• Telemedicine Access
• Wellness Programs
• Professional Development Opportunities

Pay

Compensation: $26.90 - $59.35

Exact compensation may vary based on skills, experience, and location

Schedule

Full-time position

Contact Us

To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards

To apply for this position, please visit https://careers.hcsc.com