Medical Management Specialist

4 weeks ago


Quincy, Illinois, United States PSG Global Solutions Careers Full time
Medical Management Specialist Opportunity

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.
About Our Client

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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