Behavioral Health Care Management Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $34 - $57 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Conduct care management and health education programs for customers on government health care programs • Gather, analyze, and provide data for regulatory reports • Represent the company to members • Discuss medical needs with members • Interface with internal staff, management, external vendors, and community resources • Handle medical management and health education programs independently • Travel within the assigned territory as needed

🎯 Requirements

• Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting, or an unrestricted LPC, LMSW, LCPC, LCSW, LMFT, LPCC, LISW, or LMHC license as specified by state • Current, valid, unrestricted license in the state of operations (or reciprocity) • Compact-license RN changing permanent residence must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire • 3 years wellness or managed care experience presenting clinical issues with members/physicians • Experience handling medical management programs and health education programs independently • Knowledge of the health and wellness marketplace and employer trends • Verbal and written communication skills for discussing medical needs and interfacing with staff, management, vendors, and community resources • Experience with medical data analysis • PC proficiency including Word, Excel, PowerPoint, databases, and web-based applications • Ability and willingness to travel within assigned territory • Preferred: 3 years clinical experience • Preferred: Behavioral Health Experience • Preferred: Patient education experience • Preferred: Condition Management experience • Preferred: Bilingual in English and Spanish • Preferred: Experience managing complex or catastrophic cases • Preferred: Certification in Case Management, Training, Project Management, or nationally recognized health care certification • Preferred: Government Programs experience • Preferred: Population Management

🏖️ Benefits

• Curated development plans fostering growth and professional development • Employee referral process • Union role • Equal opportunity workplace • Drug-free and smoke-free workplace