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Healthcare Management Specialist
2 months ago
We are seeking a skilled Behavioral Health Care Management Specialist to join our team at Health Care Service Corporation. As a key member of our organization, you will play a critical role in delivering high-quality care to our customers.
Key Responsibilities- Conduct care management and health education programs for customers on government health care programs.
- Analyze and provide data for regulatory reports.
- Perform assessments, care planning, and other care reviews in the member/family home and telephonically.
- Represent the company to members, providers, and state regulators.
To be successful in this role, you will need:
- A Registered Nurse (RN) with 2 years of direct clinical care experience or an unrestricted Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), Licensed Independent Social Worker (LISW), or Licensed Mental Health Counselor (LMHC) with 2 years of clinical practice experience.
- A current, valid, unrestricted license in the state of New Mexico (or reciprocity).
- Experience handling medical management programs and health education programs in an independent manner.
- 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.
We are looking for candidates with:
- Plus 1 year of wellness or managed care experience presenting clinical issues with members/physicians.
- 3 years of clinical experience.
- Care Coordination experience.
- Patient education experience.
- Condition Management experience.
- Bilingual in English and Spanish.
- Experience in managing complex or catastrophic cases.
- Certification in Case Management, Training, Project Management, or nationally recognized healthcare certification.
We are an Equal Opportunity Employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.