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Medical Management Specialist I

4 months ago

Downers Grove, United States Integrated Resources Full time
Job Title: Medical Management Specialist I
Job Location: Downers Grove, Cook, Lake, McHenry, or Champaign counties, IL (Remote + Field Visits)
Duration: 6 months
Shift: Monday to Friday 8:00am - 5:00pm

Job Description:
  • Responsible for conducting medical management and health education programs for customers on government health care programs.
  • Accountabilities include gathering, analyzing, and providing data for regulatory reports. This position will represent the company to members.

Job Qualifications:
  • Registered Nurse (RN), with 3 years direct clinical care to the consumer in a clinical setting or Licensed Professional Counselor (LPC), or Licensed Master Social Worker (LMSW), which includes 2 years of clinical practice to obtain their LPC or LMSW license.
  • 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.
  • Current driver's license, transportation, and applicable insurance.
  • Ability and willingness to travel within assigned territory.
  • PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.


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