Position: Medical Management Specialist (Case Manager)
Location: Pontiac/Toluca/El Paso IL Area.
Benefits eligible + 401K. An Excel and typing speed test must be completed.
Job Description:
This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory reports. This position will represent the company to members. Travel is required to patients’ homes.
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). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
- 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.
Preferred Qualifications:
- 3 years clinical experience.
- Patient education experience.
- Condition Management experience.
- Transition of Care experience.
- Experience in managing complex medical cases.
- Certification in Case Management, Training, Project Management or nationally recognized health care certification.