Job Description
We're looking for a compassionate and skilled Medical Management Specialist to join our team! In this remote position, you will be responsible for delivering medical management and health education programs to individuals enrolled in government healthcare programs. You will play a key role in gathering, analyzing, and providing data for regulatory reports. Your responsibilities will also include performing assessments, creating care plans, and coordinating care with members and their families both in person and over the phone.
You'll be representing the organization while providing valuable support to members, helping them navigate their healthcare needs with confidence.
Key Responsibilities:
Conduct medical management and health education programs for individuals in government health care programs.
Gather and analyze data to prepare reports for regulatory compliance.
Perform assessments and care coordination via phone and in-person visits to members/families.
Develop care plans tailored to individual needs.
Represent the organization professionally when interacting with members, healthcare providers, and community resources.
Travel within your assigned territory as needed.
Required Qualifications:
Registered Nurse (RN) with at least 3 years of direct clinical care experience, OR
Licensed Professional Counselor (LPC) or Licensed Master Social Worker (LMSW) with at least 2 years of clinical experience.
A current, valid, unrestricted license in the state where you will be working (or reciprocity). If you are moving from another state, you will need to obtain an active, unrestricted RN license within 90 days of hire.
A minimum of 3 years of experience in wellness or managed care, with experience presenting clinical issues to members or physicians.
Knowledge of the health and wellness industry, including trends in employer health care offerings.
Strong communication skills, both verbal and written, with the ability to discuss medical needs with members and collaborate with internal teams and external partners.
Analytical skills with experience in reviewing medical data.
Ability and willingness to travel within the assigned region.
Proficiency in Microsoft Word, Excel, PowerPoint, and web-based applications.
Preferred Qualifications:
3 years of clinical experience.
Patient education experience.
Experience in Condition Management.
Bilingual in English and Spanish (preferred, but not required).
Experience with Transition of Care.
Experience managing complex or catastrophic health cases.
Certification in Case Management, Project Management, or a nationally recognized healthcare certification (preferred, but not required).
Why Join Us?
This is a fantastic opportunity for someone with a passion for healthcare and making a difference in the lives of others. As a contractor, you'll enjoy flexibility and the opportunity to work remotely while contributing to essential healthcare programs.
If you are dedicated to helping people and have the right qualifications, we would love to hear from you!
Employment Type: Full-Time
Salary: $ 35.00 40.00 Per Hour
Job Tags
Hourly pay, Full time, For contractors, Remote work,