Government Programs Care Manager III

🕒 2 days ago

🌽 Illinois – Remote

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💵 $34 - $57 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Logo of Health Care Service Corporation

Health Care Service Corporation

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

• Provide care coordination to members through telephonic and/or field-based care management • Inform and educate members about health care programs addressing personal health needs • Engage members in discussions about adherence to personal health goals • Respond to member inquiries • Support clinical operations with provider and member activities • Complete telephonic and/or field-based health screenings • Conduct comprehensive health assessments and care planning • Visit members’ homes and/or facilities as needed to support complex and specialty populations • Present clinical issues to members and physicians • Interface with internal staff, management, external vendors, and community resources • Travel within the assigned territory

🎯 Requirements

• Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting, or an applicable unrestricted behavioral-health license (LPC, LMSW, LCPC, LCSW, LMFT, LPCC, LISW, or LMHC) with 2 years of clinical practice experience • Current, valid, unrestricted license in the state of operations (or reciprocity) • Compact RN licensees 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 • Knowledge of the health and wellness marketplace and employer trends • Verbal and written communication skills for discussing medical needs and interfacing with internal staff, management, external vendors, and community resources • Analytical experience including medical data analysis • PC proficiency including Word, Excel, PowerPoint, databases, and web-based applications • Current unrestricted driver’s license, transportation, and applicable insurance • Ability and willingness to travel within assigned territory • Illinois-specific waiver qualifications as listed, including applicable RN, social-work, counseling, nursing, case-management, human-services, or related credentials and experience • Texas-specific experience working with children and young adults with similar behavioral-health conditions or behaviors in three of the last five years • Preferred: 3 years direct clinical 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 experience • Preferred: MCO case management experience • Must reside within a 60-mile radius of the Chicago office • Remote work permitted within the continental United States, excluding California, New York, Alaska, and Hawaii

🏖️ Benefits

• Curated development plans supporting professional development and career growth • Union role • Remote/telecommute work arrangement

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