BH Government Programs Care Manager III - 743 jobs in United States
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Health Care Service Corporation · 9 hours ago

BH 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 Care Manager III is responsible for providing care coordination and education to members, conducting health screenings and assessments, and supporting clinical operations.

Health InsuranceInsurance
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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
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
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 Counselor (LPC)Licensed Clinical Social Worker (LCSW)WellnessManaged care experienceMedical management programsHealth education programsAnalytical experiencePC proficiencyPatient education experienceCondition Management experienceGovernment Programs experiencePopulation ManagementBilingual in EnglishSpanishVerbal 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

Preferred

3 years 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

Company

Health Care Service Corporation

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Health Care Service Corporation is a customer-owned health insurance company.