Government Programs Care Manager III

🔥 2 minutes ago

🌶️ New Mexico – Remote

🌶️ New Mexico – Remote

💵 $26 - $59 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 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

• Provide care coordination to members through telephonic and/or field-based care management • Inform and educate members on 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 member 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 experience, or specified unrestricted behavioral health/social work license 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 • 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 • Analytical experience including medical data analysis • PC proficiency including 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 • State-specific qualifications for Illinois and Texas programs as listed • 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

🏖️ Benefits

• Professional development plans • Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan