Health Care Service Corporation

Government Programs Care Manager III - Work From Home

Health Care Service Corporation$55K — $123K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Registered Nurse (RN) with 2 years direct clinical experience or various licensed clinical professionals with 2 years clinical practice.
  • Current, valid, unrestricted state license to practice; compact licensees must achieve active licensure within 90 days.
  • 3 years of managed care or wellness experience presenting clinical issues to members/physicians.
  • Strong knowledge of the health and wellness marketplace and trends.
  • Excellent verbal and written communication skills to effectively engage with members and providers.
  • Proficient in medical data analysis and general computer skills including Microsoft Office and web-based applications.
  • Current driver’s license and ability to travel within assigned territory.

Responsibilities

  • Provide telephonic and field-based care coordination to members.
  • Educate members on healthcare programs and personal health goals.
  • Conduct health screenings and comprehensive assessments for members.
  • Create care plans that support complex and specialty populations.
  • Respond to inquiries from members and provide support for clinical operations.
  • Collaborate with internal staff and external resources to enhance member care.
  • Engage with providers to facilitate member health needs.

Benefits

  • Comprehensive health and wellness benefits.
  • 401(k) savings and pension plans.
  • Paid time off and parental leave.
  • Disability and supplemental life insurance.
  • Employee assistance program and paid holidays.
  • Tuition reimbursement and additional incentives.
Full Job Description
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, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations

Required Job Qualifications:
  • 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), 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 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.
  • PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications.
  • Current unrestricted driver's license, transportation and applicable insurance.
  • Ability and willingness to travel within assigned territory.


Additional State Specific Requirements
  • Texas Only:
    • Level 3 children with behavioral health issues-experience in working with children and young adjusts with similar conditions or behaviors in three of the last 5 years

Preferred Job Qualifications:
  • 3 years direct 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


Field sites located in the Bryan/College Station, TX area.

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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 https://careers.hcsc.com/totalrewards.

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.

Base Pay Range
$26.90 - $59.35

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

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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