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Medical Management Specialist I

Medical Management Specialist I

Integrated ResourcesAlamogordo, NM, United States
30+ days ago
Job type
  • Permanent
Job description

Job Title : Medical Management Specialist I

Job Location : Tao, NM (remote, but candidates must reside near location)

Job Duration : 3 Months (possibility of extension)

JOB PURPOSE :

  • This position is responsible for conducting medical management and health education programs for customers on government health care programs.
  • This role will include gathering, analyzing and providing date for regulatory reports.
  • Accountabilities include gathering, analyzing and providing date for regulatory reports.
  • Perform assessments, care planning and care coordination in the member / family home and telephonically.
  • This position will represent the company to members.

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 JOB QUALIFICATIONS :

  • 3 years 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 health care certification.
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    Medical Management Specialist • Alamogordo, NM, United States

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