Medical Management Specialist
4 weeks ago
At PSG Global Solutions Careers, we're seeking a highly skilled Medical Management Specialist to join our team. As a key member of our healthcare team, you will play a critical role in conducting medical management and health education programs for customers on government health care programs.
- Develop and implement effective medical management strategies to improve patient outcomes and reduce healthcare costs.
- Collaborate with healthcare professionals to gather, analyze, and provide data for regulatory reports.
- Represent our company to members, providing exceptional customer service and support.
Our client is a fast-growing industry-recognized staffing firm with 20+ years of experience and a strong reputation for recruiting top talent in IT, Financial, Engineering, Healthcare, and Data Analytics. With a focus on building long-lasting partnerships and growth, we're committed to finding the right fit for our clients and candidates.
Requirements for Success- Registered Nurse (RN), Licensed Professional Counselor (LCPC), or Licensed Master Social Worker (LMSW) with 2 years direct clinical care to the consumer in a clinical setting.
- Current, valid, unrestricted license in the state of operations (or reciprocity).
- 3+ years wellness or managed care experience presenting clinical issues with members/physicians.
- 3 years clinical experience preferred.
- Patient education experience preferred.
- Condition Management experience preferred.
- Bilingual in English and Spanish preferred.
- Experience in managing complex or catastrophic cases preferred.
- Certification in Case Management, Training, Project Management or nationally recognized healthcare certification preferred.
- 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, including Word, Excel, and PowerPoint, database experience, and Web-based applications.
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