BH Government Programs Care Manager III

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible to provide care coordination to members via telephonic and / or field based care management to inform and educate them on health care programs to address their personal health needs, engage the member in adherence to personal health goals, respond to inquiries from members, and support the clinical operations department with their provider and member activities. This position will be required to complete member telephone and / or field based health screenings, comprehensive health assessments and care planning duties which may require visits to members' home and / or facilities to support complex and specialty populations.

JOB REQUIREMENTS :

Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX, NM), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist (LMFT, IL & NM), Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience. 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 3years wellness or managed care experience presenting clinical issues with members / physicians.

Experience handling medical management programs and health educations 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 to include Word, Excel, and PowerPoint, database experience and Web based applications.

Ability and willingness to travel within assigned territory.

PREFERRED JOB REQUIREMENTS :

3 years clinical 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 health care certification.

Government Programs experience

Population Management

#LI-AC1

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement :

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement :

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are 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.

Base Pay Range

$26.37 - $58.19

Exact compensation may vary based on skills, experience, and location.

Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.

Join our Talent Community. ()

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

© Copyright 2025 Health Care Service Corporation. All Rights Reserved.