Hybrid Medical Management Specialist

6 days ago


Chicago, Illinois, United States Solving IT Full time

Job Summary

Solving IT, a leading healthcare technology company, is seeking a highly skilled Hybrid Medical Management Specialist to join our team. As a key member of our organization, you will play a critical role in conducting medical management and health education programs for customers on government health care programs.

Key Responsibilities

  • Conduct medical management and health education programs for customers on government health care programs.
  • Gather, analyze, and provide data for regulatory reports.
  • Represent the company to members and provide excellent customer service.
  • Collaborate with internal staff and external vendors to ensure seamless program execution.

Requirements

  • Registered Nurse (RN) with 3 years of direct clinical care experience or Licensed Professional Counselor (LPC) or Licensed Master Social Worker (LMSW) with 2 years of clinical practice experience.
  • Current, valid, unrestricted license in the state of operations (or reciprocity).
  • Plus 3 years of 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 IL driver's license, transportation, and applicable insurance (for IL).
  • Ability and willingness to travel within assigned territory.
  • PC proficiency, including Word, Excel, and PowerPoint, database experience, and Web-based applications.

Preferred Requirements

  • 3 years of clinical experience.
  • Patient education experience.
  • Condition Management experience.
  • Bilingual in English and Spanish.
  • Transition of Care experience.
  • Experience in managing complex or catastrophic cases.
  • Certification in Case Management, Training, Project Management, or nationally recognized healthcare certification.

Benefits

Solving IT offers a comprehensive benefit package to all W2 employees and their families, including five diverse health plan options, a PPO dental plan, Term Life/AD&D Insurance, and a 401(k) Savings Plan. We cover a portion of the health and dental premiums for our employees.

Why Join Solving IT?

We champion equality and embrace diversity in all its forms. Creating an atmosphere that encourages varied perspectives to collaborate fosters personal development, strengthens team unity, and contributes to the overall success of the organization. Whether you're seeking your next career challenge or aiming to stay abreast of industry trends, Solving IT is committed to supporting your career advancement.



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